Relative Efficacy of Tegaserod in a Systematic Review and Network Meta-analysis of Licensed Therapies for Irritable Bowel Syndrome With Constipation

Abstract

Irritable bowel syndrome (IBS) is a chronic functional bowel disorder affecting 1 in 10 people and associated with poor psychological health, reduced quality of life, and increased health care expenditure.¹ The etiology is complex and incompletely understood.² Approximately one-third of patients have IBS with constipation (IBS-C),¹ for which there are licensed therapies available in the United States. We summarized comparative efficacy of these in a recent network meta-analysis of randomized controlled trials (RCTs).³ Tegaserod, a 5-hydroxytryptamine-4 receptor agonist, approved by the Food and Drug Administration (FDA) for IBS-C, was withdrawn in 2007 after a small excess number of cerebrovascular and cardiovascular ischemic events in patients taking the drug.⁴ However, since our network meta-analysis, it has been reintroduced in the United States. It is therefore important to understand its efficacy relative to other available licensed therapies for IBS-C.