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Effect of antispasmodic agents, alone or in combination, in the treatment of Irritable Bowel Syndrome: systematic review and meta-analysis.
Rev Gastroenterol Mex. 2012 Apr-Jun; 77(2):82-90.RG

Abstract

INTRODUCTION

Irritable bowel syndrome (IBS) is characterized by recurrent abdominal pain, bloating, and changes in bowel habit.

AIMS

To determine the clinical effectiveness of the antispasmodic agents available in Mexico for the treatment of IBS.

METHODS

We carried out a systematic review and meta-analysis of randomized controlled clinical trials on antispasmodic agents for IBS treatment. Clinical trials identified from January 1960 to May 2011 were searched for in MEDLINE, the Cochrane Library, and in the ClinicalTrials.gov registry. Treatment response was evaluated by global improvement of symptoms or abdominal pain, abdominal distention/bloating, and frequency of adverse events. The effect of antispasmodics vs placebo was expressed in OR and 95% CI.

RESULTS

Twenty-seven studies were identified, 23 of which fulfilled inclusion criteria. The studied agents were pinaverium bromide, mebeverine, otilonium, trimebutine, alverine, hyoscine, alverine/simethicone, pinaverium/simethicone, fenoverine, and dicyclomine. A total of 2585 patients were included in the meta-analysis. Global improvement was 1.55 (CI 95%: 1.33 to 1.83). Otilonium and the alverine/simethicone combination produced significant values in global improvement while the pinaverium/simethicone combination showed improvement in bloating. As for pain, 2394 patients were included with an OR of 1.52 (IC 95%: 1.28 a 1.80), favoring antispasmodics.

CONCLUSIONS

Antispasmodics were more effective than placebo in IBS, without any significant adverse events. The addition of simethicone improved the properties of the antispasmodic agents, as seen with the alverine/simethicone and pinaverium/simethicone combinations.

Authors+Show Affiliations

Gastroenterology Unit, Internal Medicine Department, Dr José E González University Hospital, Monterrey, NL, Mexico.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Systematic Review

Language

eng

PubMed ID

22672854

Citation

Martínez-Vázquez, M A., et al. "Effect of Antispasmodic Agents, Alone or in Combination, in the Treatment of Irritable Bowel Syndrome: Systematic Review and Meta-analysis." Revista De Gastroenterologia De Mexico, vol. 77, no. 2, 2012, pp. 82-90.
Martínez-Vázquez MA, Vázquez-Elizondo G, González-González JA, et al. Effect of antispasmodic agents, alone or in combination, in the treatment of Irritable Bowel Syndrome: systematic review and meta-analysis. Rev Gastroenterol Mex. 2012;77(2):82-90.
Martínez-Vázquez, M. A., Vázquez-Elizondo, G., González-González, J. A., Gutiérrez-Udave, R., Maldonado-Garza, H. J., & Bosques-Padilla, F. J. (2012). Effect of antispasmodic agents, alone or in combination, in the treatment of Irritable Bowel Syndrome: systematic review and meta-analysis. Revista De Gastroenterologia De Mexico, 77(2), 82-90. https://doi.org/10.1016/j.rgmx.2012.04.002
Martínez-Vázquez MA, et al. Effect of Antispasmodic Agents, Alone or in Combination, in the Treatment of Irritable Bowel Syndrome: Systematic Review and Meta-analysis. Rev Gastroenterol Mex. 2012 Apr-Jun;77(2):82-90. PubMed PMID: 22672854.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of antispasmodic agents, alone or in combination, in the treatment of Irritable Bowel Syndrome: systematic review and meta-analysis. AU - Martínez-Vázquez,M A, AU - Vázquez-Elizondo,G, AU - González-González,J A, AU - Gutiérrez-Udave,R, AU - Maldonado-Garza,H J, AU - Bosques-Padilla,F J, Y1 - 2012/06/05/ PY - 2011/10/22/received PY - 2012/04/28/accepted PY - 2012/6/8/entrez PY - 2012/6/8/pubmed PY - 2013/12/18/medline SP - 82 EP - 90 JF - Revista de gastroenterologia de Mexico JO - Rev Gastroenterol Mex VL - 77 IS - 2 N2 - INTRODUCTION: Irritable bowel syndrome (IBS) is characterized by recurrent abdominal pain, bloating, and changes in bowel habit. AIMS: To determine the clinical effectiveness of the antispasmodic agents available in Mexico for the treatment of IBS. METHODS: We carried out a systematic review and meta-analysis of randomized controlled clinical trials on antispasmodic agents for IBS treatment. Clinical trials identified from January 1960 to May 2011 were searched for in MEDLINE, the Cochrane Library, and in the ClinicalTrials.gov registry. Treatment response was evaluated by global improvement of symptoms or abdominal pain, abdominal distention/bloating, and frequency of adverse events. The effect of antispasmodics vs placebo was expressed in OR and 95% CI. RESULTS: Twenty-seven studies were identified, 23 of which fulfilled inclusion criteria. The studied agents were pinaverium bromide, mebeverine, otilonium, trimebutine, alverine, hyoscine, alverine/simethicone, pinaverium/simethicone, fenoverine, and dicyclomine. A total of 2585 patients were included in the meta-analysis. Global improvement was 1.55 (CI 95%: 1.33 to 1.83). Otilonium and the alverine/simethicone combination produced significant values in global improvement while the pinaverium/simethicone combination showed improvement in bloating. As for pain, 2394 patients were included with an OR of 1.52 (IC 95%: 1.28 a 1.80), favoring antispasmodics. CONCLUSIONS: Antispasmodics were more effective than placebo in IBS, without any significant adverse events. The addition of simethicone improved the properties of the antispasmodic agents, as seen with the alverine/simethicone and pinaverium/simethicone combinations. SN - 0375-0906 UR - https://www.unboundmedicine.com/medline/citation/22672854/Effect_of_antispasmodic_agents_alone_or_in_combination_in_the_treatment_of_Irritable_Bowel_Syndrome:_systematic_review_and_meta_analysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0375-0906(12)00010-9 DB - PRIME DP - Unbound Medicine ER -