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Downloaded from http://journals.lww.com/ajg by BhDMf5ePHKbH4TTImqenVA5KvPVPZ0P5BEgU+IUTEfzO/GUWifn2IfwcEVVH9SSn on 06/03/2020 CLINICAL AND SYSTEMATIC REVIEWS 329 CME Effi cacy and Tolerability of Guanylate Cyclase-C Agonists for Irritable Bowel Syndrome with Constipation and Chronic Idiopathic Constipation: A Systematic Review and Meta-Analysis 1 2 1 , 3 Eric D. Shah , MD, MBA , Hyungjin Myra Kim , ScD and Philip Schoenfeld , MD, MS OBJECTIVES: Linaclotide and plecanatide are guanylate cyclase-C (GCC) agonists for the treatment of chronic idiopathic constipation (CIC) and irritable bowel syndrome with constipation (IBS-C). Our objective is to evaluate the effi cacy and tolerability of GCC agonists based on data from multiple randomized controlled trials (RCTs). METHODS: We searched PubMED, EMBASE, Cochrane databases, clinicaltrials.gov, major conference abstracts, Food and Drug Administration (FDA) websites, and United States Securities and Exchange Commission fi lings of drug sponsors to identify RCTs of CIC or IBS-C patients. We assessed effi cacy based on FDA- approved composite responder endpoints, diarrhea as an adverse event, and study withdrawal owing to diarrhea for each therapy. Trial results were pooled using DerSimonian and Laird random effects model of meta-analysis and exact logistic regression when appropriate with 95% confi dence intervals. Meta- regression was performed to compare outcomes between
American Journal of Gastroenterology – Wolters Kluwer Health
Published: Mar 1, 2018
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