New drug relieves severe chronic constipation

May 29th, 2008 - 1:33 pm ICT by admin  

Washington, May 29 (IANS) A promising, but as yet unapproved, new drug overcomes severe chronic constipation while minimising the possibility of cardiac-related side effects, according to a study. Under the study, 620 patients were randomly assigned to receive either of two dosage levels of prucalopride, a drug that stimulates protein receptors involved in colon contraction - or a placebo.

All the patients averaged only one bowel movement during the fortnight before treatment, while most had struggled with the problem for several years.

“Many more of the patients taking prucalopride were able to have spontaneous bowel movements without taking enemas or laxatives, as compared to those who were given the placebo,” said Michael Camilleri of Mayo Clinic, who led the study.

“The time it took to have a first bowel movement was much shorter, and quality of life and other abdominal symptoms also were improved for those taking the study drug.”

Constipation is a common medical problem, affecting millions worldwide with expenditure on laxatives and other treatments alone running into billions of dollars every year.

Prevalence is higher among women and is particularly acute in the elderly. The study involved patients with an extreme but common version of constipation called severe chronic constipation.

“The normal range of bowel movements is anywhere from three per day to three per week,” explained Camilleri.

The two mg and 4 mg doses of prucalopride appeared roughly equal in benefit, with about 30 percent of patients averaging three bowel movements per week during the 12-week study.

The most common adverse effect from the drug was diarrhoea, which tended to occur in the early stages of treatment, but most patients later settled into a more normal routine of bowel movements. Headaches were a less frequent side effect.

Camilleri said cardiac risk issues that have been raised about related drugs for constipation including tegaserod, appear to be less of a concern for prucalopride.

Prucalopride is not yet approved for use in the US or in any other country.

These findings have been published this week in the New England Journal of Medicine.

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