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Prucalopride improved bowel function, colonic transit time in patients with chronic constipation
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Longer colonic transit time was associated with increased symptom severity in patients with chronic constipation and treatment with prucalopride improved bowel function and colonic transit time, according to new study results.
In an integrated analysis of three randomized, placebo-controlled, phase 2 dose-finding trials, the effectiveness of prucalopride was assessed in patients with chronic constipation. Colonic transit time (CTT) was evaluated in 280 patients (mean age, 43 years; 93% women; 19 years mean duration of constipation) using radio-opaque markers at the beginning and end of a 4-week or 12-week treatment period.
After prucalopride 2 mg treatment once daily (n=98) and 4 mg treatment once daily (n=70), CTT was reduced by 12.0 hours (95% CI, -18.9 to -5.1) and 13.9 hours (95% CI, -20.5 to -7.4) respectively. In patients with placebo (n=112), CTT increased by 0.5 hours (95% CI, -4.5 to 5.5).
A higher proportion of patients with slow or very slow CTT (>48 hours) reported severe or very severe symptoms of bloating/flatulence/distension and straining compared to those with normal CTT.
“The prucalopride-induced reduction in CTT is the mechanism resulting in stool softening,” the study authors wrote, but “if transit remains slow following treatment, this improvement in stool consistency does not occur.”
Disclosure: Financial support was provided by Shire-Movetis NV, Turnhout, Belgium. Anton Emmanuel has served on advisory boards for Shire. Rene´ Kerstens, Marina Cools and Lieve Vandeplassche were employees of Shire at the time the analysis was conducted.
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