Clinical trial: the efficacy, impact on quality of life, and safety and tolerability of prucalopride in severe chronic constipation--a 12-week, randomized, double-blind, placebo-controlled study.
BACKGROUND
Chronic constipation may result in disabling symptoms, is often unsatisfactorily treated by laxatives and negatively impacts quality of life (QoL).


OBJECTIVE
A randomized, double-blind, placebo-controlled, phase III trial to evaluate the efficacy and safety of a selective, high-affinity 5-HT(4) receptor agonist, prucalopride, in patients with chronic constipation [<or=2 spontaneous complete bowel movements (SCBMs)/week].


METHODS
Placebo, 2 or 4 mg prucalopride was administered orally once daily, for 12 weeks. The primary efficacy endpoint was the proportion of patients with >or=3 SCBMs/week, averaged over 12 weeks. Other assessments included BM frequency, constipation-related QoL and symptoms and tolerability.


RESULTS
Among 641 patients, significantly more patients taking prucalopride 2 or 4 mg (24%) than placebo (12%), achieved the primary efficacy endpoint (>or=3 SCBMs/week) or an increase of >or=1 SCBMs/week; 43% and 47% vs. 28% respectively. Prucalopride-treated patients also achieved significantly greater satisfaction with treatment and bowel function, and improved perception of constipation severity and constipation-related QoL, compared with placebo. Most frequent treatment-related adverse events were headache, abdominal pain, nausea and diarrhoea (mainly during day 1). There were no differences in comparison to placebo in the incidence of serious adverse effects or cardiovascular events.


CONCLUSIONS
Over 12 weeks, prucalopride was effective and well tolerated in chronic constipation.
Quigley
E M M
EM
Alimentary Pharmabiotic Centre, University College Cork, Cork, Ireland. e.quigley@ucc.ie
Vandeplassche
L
L
Kerstens
R
R
Ausma
J
J
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001572:Benzofurans / Q000008:administration & dosage* / Q000009:adverse effects; D002908:Chronic Disease; D003248:Constipation / Q000188:drug therapy* / Q000523:psychology; D003672:Defecation / Q000187:drug effects; D004311:Double-Blind Method; D005260:Female; D005772:Gastrointestinal Transit / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010919:Placebos / Q000008:administration & dosage* / Q000009:adverse effects; D011788:Quality of Life / Q000523:psychology; D017366:Serotonin Receptor Agonists / Q000008:administration & dosage* / Q000009:adverse effects; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
D001572:Benzofurans; D010919:Placebos; D017366:Serotonin Receptor Agonists; C406662:prucalopride