Tegaserod: long-term treatment for irritable bowel syndrome patients with constipation in primary care

Digestion. 2005;71(4):238-44. doi: 10.1159/000087049. Epub 2005 Jul 12.

Abstract

Background: Tegaserod, a prokinetic 5-HT4 receptor agonist, has demonstrated efficacy and tolerability in irritable bowel syndrome (IBS) patients with constipation (IBS-C) in controlled clinical trials. Its use in primary care has not been investigated.

Aim: To determine whether tegaserod is effective and well tolerated by primary care IBS-C patients.

Methods: Patients received tegaserod 6 mg b.i.d. for 12 weeks and were assessed for response, abdominal pain/discomfort, bloating, stool consistency/frequency and straining at weeks 4 and 12. Previous successful treatment with the withdrawn drug, cisapride, was noted. A 9-month study extension was offered to patients completing 12 weeks of tegaserod treatment.

Results: 212 patients entered the 12-week treatment period; 166 completed as planned. Response rates were 64.2% at week 4 and 70.3% at week 12. After 12 weeks, abdominal pain/discomfort and bloating were reduced from baseline (p < 0.0001; mean change -1.02 and -0.91 points, respectively), stool frequency increased (0.78-0.97 stools/day) and stool consistency improved (2.45-3.42; lumpy stools became softer). Tegaserod was well tolerated; the most common adverse events were headache (13.2%) and diarrhea (9.4%). One hundred and twenty patients entered the 9-month extension study, 85 completed and tegaserod continued to be well tolerated.

Conclusions: In ambulatory primary care IBS-C patients, tegaserod is an effective and well-tolerated long-term treatment.

MeSH terms

  • Constipation / complications
  • Constipation / drug therapy*
  • Female
  • Gastrointestinal Agents / administration & dosage
  • Gastrointestinal Agents / therapeutic use*
  • Humans
  • Indoles / administration & dosage
  • Indoles / therapeutic use*
  • Irritable Bowel Syndrome / complications
  • Irritable Bowel Syndrome / drug therapy*
  • Male
  • Middle Aged
  • Primary Health Care*
  • Treatment Outcome

Substances

  • Gastrointestinal Agents
  • Indoles
  • tegaserod