title: Long-term outcome of prucalopride for chronic constipation: a single-centre study.
abstract: OBJECTIVE
  Newer 5-hydroxytryptamine agonists, such as prucalopride, have been demonstrated to be effective in the short term for treatment of chronic constipation. To date, few studies have investigated their medium- and long-term effectiveness.
  
  
  METHODS
  An analysis was carried out of a prospectively maintained database of all patients started on prucalopride for chronic constipation between April 2011 and April 2014. Cleveland Clinic Constipation Score (CCCS) questionnaires were administered before starting treatment with prucalopride and at the first follow-up visit to assess change in CCCS scores in 50 randomly selected patients.
  
  
  RESULTS
  A total of 155 patients (median age: 47 years; seven men) were started on prucalopride in this period. Of these, 16 (10%) had slow-transit constipation, 31 (20%) had obstructive defaecation syndrome and 30 (19%) had a combination of both. Of these 155 patients, 78% patients were on three or more laxatives at the time of starting prucalopride. Patients were started on 1 mg or 2 mg according to their age. The median follow-up period was 24 (range: 4-40) months. At the first follow-up visit, 106 (68%) patients reported good symptomatic improvement, whereas the remainder had no response. Third of initial responders showed decreased efficacy after a median duration of 6 months and needed regular laxatives/irrigation. Of the 50 patients who filled in the CCCS questionnaires (15 patients were nonresponders), 32 (64%) reported improved scores with a median improvement of two points per criterion.
  
  
  CONCLUSIONS
  This study provides evidence that prolonged use of prucalopride is effective in achieving a sustained benefit in the majority of patients.
authors.affiliation: Department of Colorectal Surgery, Prince Charles Hospital, Merthyr Tydfil, UK.
authors.forename: P K
authors.initials: PK
authors.lastname: Dhruva Rao
authors.affiliation: Department of Colorectal Surgery, Prince Charles Hospital, Merthyr Tydfil, UK.
authors.forename: M
authors.initials: M
authors.lastname: Lewis
authors.affiliation: Department of Colorectal Surgery, Prince Charles Hospital, Merthyr Tydfil, UK.
authors.forename: S P M
authors.initials: SP
authors.lastname: Peiris
authors.affiliation: Department of Colorectal Surgery, Prince Charles Hospital, Merthyr Tydfil, UK.|University of South Wales, Pontypridd, UK.
authors.forename: P R
authors.initials: PR
authors.lastname: Shah
authors.affiliation: Department of Colorectal Surgery, Prince Charles Hospital, Merthyr Tydfil, UK.|University of South Wales, Pontypridd, UK.
authors.forename: P N
authors.initials: PN
authors.lastname: Haray
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001572:Benzofurans / Q000008:administration & dosage*; D002908:Chronic Disease / Q000188:drug therapy; D003248:Constipation / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D054368:Laxatives / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D001572:Benzofurans; D054368:Laxatives; C406662:prucalopride
keywords: Chronic constipation; obstructive defaecation; prucalopride; slow transit constipation