January 21, 2019
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Pregabalin effective for treating pain, bloating, diarrhea in IBS

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Pregabalin — a calcium channel alpha 2 delta ligand — helped treat visceral hypersensitivity in patients with irritable bowel syndrome and reduced symptoms of abdominal pain, bloating and diarrhea, according to research published in Alimentary Pharmacology & Therapeutics.

Yuri A. Saito, MD, of the division of gastroenterology and hepatology at the Mayo Clinic in Rochester, Minnesota, and colleagues wrote that visceral hypersensitivity is a common symptom of IBS and can be treated with several therapies. However, these treatments do not work for all patients.

“Data on pregabalin’s effects on visceral pain and IBS are limited but suggest the drug does reduce gut visceral hypersensitivity,” they wrote. “Because of its known effects on pain, we postulated that pregabalin would decrease bowel symptoms — particularly IBSrelated abdominal pain or discomfort.”

Researchers conducted a double-blind, placebo-controlled trial to assess the efficacy of pregabalin on gastrointestinal symptoms of IBS. The trial comprised 85 patients that met Rome III criteria with at least three pain attacks per month. Researchers randomly assigned patients to receive either 225 mg of pregabalin (n = 41) or placebo (n = 44) twice daily for 12 weeks.

Patients completed questionnaires weekly, and the primary endpoint was average pain Bowel Symptom Severity Scale (BSS) scores for weeks 9 through 12.

Patients in the pregabalin cohort reported lower average pain-BSS scores for weeks 9 through 12 (25 vs. 42; P = .008) and had lower overall IBD BSS severity scores (26 vs. 42; P = .009).

Investigators also observed differences between diarrhea-BSS (P = .049) and bloating-BSS (P = .016) scores.

Saito and colleagues wrote that the benefit was apparent in patients with diarrhea-predominant and mixed-type IBS. Meanwhile, pregabalin did not appear to effect constipation scores.

“Our study provides novel and important data suggesting a positive effect of pregabalin on IBS symptoms, particularly for mixed-type IBS and diarrhea-predominant IBS patients,” they wrote. “A large multicenter trial of IBSD or IBSM patients utilizing the FDA outcome should be pursued as pregabalin shows promise and treatment options for IBS-related pain and mixed bowel habit IBS remain limited.” – by Alex Young

Disclosures: The authors report no relevant financial disclosures.