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Improvement in pain and bowel function in female irritable bowel patients with alosetron, a 5‐HT 3 receptor antagonist
Author(s) -
Michael Camilleri,
Emeran A. Mayer,
Douglas A. Drossman,
Amy Heath,
George E. Dukes,
David McSorley,
S Kong,
Allen W. Mangel,
Allison R. Northcutt
Publication year - 1999
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.1999.00610.x
Subject(s) - medicine , irritable bowel syndrome , placebo , constipation , gastroenterology , abdominal pain , defecation , pathology , alternative medicine
Background : No currently available treatment provides consistent relief of irritable bowel syndrome. Colonic sensory and motor function are modulated partly through 5HT 3 ‐receptors. Aim : To evaluate effects of the 5HT 3 ‐receptor antagonist, alosetron, in irritable bowel syndrome. Methods : Randomized, double‐blind, placebo‐controlled, dose‐ranging (1, 2, 4, 8 mg b.d. alosetron), 12‐week trial in 370 patients with diarrhoea‐predominant or alternating constipation and diarrhoea irritable bowel syndrome. Weekly measurement of adequate relief was the key end‐point; other irritable bowel syndrome symptoms were collected daily using an electronic phone system. Results : Alosetron (1 mg or 2 mg b.d.) significantly ( P < 0.05 vs. placebo) increased the proportion of females, but not males, reporting adequate relief. Stool consistency, frequency and percentage days with urgency improved over placebo ( P < 0.05) within the first month with all doses of alosetron, and persisted throughout the trial with all doses in female patients. With 1 mg b.d. alosetron, females had improved stool consistency and urgency within the first week, and adequate relief and improved stool frequency within the first 2 weeks. There was no consistent improvement in bowel function among male patients. Conclusion : In female irritable bowel syndrome patients with predominant diarrhoea or alternating constipation and diarrhoea, alosetron is effective in treatment of abdominal pain and discomfort and bowel‐related symptoms.