# PubMed- Efficacy of 5-HT(3) Antagonists and 5-HT(4) Agonists in Irritable Bowel Syndrome: Systematic Review and Meta-Analysis.



## VSsupport (Feb 12, 2008)

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*Efficacy of 5-HT(3) Antagonists and 5-HT(4) Agonists in Irritable Bowel Syndrome: Systematic Review and Meta-Analysis.*

Am J Gastroenterol. 2009 May 26;

Authors: Ford AC, Brandt LJ, Young C, Chey WD, Foxx-Orenstein AE, Moayyedi P

OBJECTIVES:Irritable bowel syndrome (IBS) is a chronic functional disorder. 5-Hydroxytryptamine (5-HT) is a key modulator of gastrointestinal sensorimotor function. Many patients have IBS that can be difficult to treat, which has led to the development of newer agents, such as 5-HT(3) antagonists and 5-HT(4) agonists. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to estimate the efficacy of all available 5-HT agents in IBS.METHODS:MEDLINE, EMBASE, and the Cochrane Controlled Trials Register were searched (up to June 2008). Trials recruiting adults with IBS in primary, secondary, or tertiary care comparing 5-HT(3) antagonists or 5-HT(4) agonists with placebo were eligible. Dichotomous symptom data were pooled to obtain a relative risk (RR) of remaining symptomatic after therapy, with a 95% confidence interval (CI). The number needed to treat (NNT) was calculated from the reciprocal of the risk difference.RESULTS:The strategic search identified 1,593 citations. A total of 29 RCTs were eligible for inclusion; placebo was compared with 5-HT(3) antagonists in 11 RCTs, with tegaserod in 11, and with mixed 5-HT(3) antagonists/5-HT(4) agonists in 7. The study quality was generally high. The RR of IBS symptoms persisting with 5-HT(3) antagonists vs. placebo was 0.78 (95% CI: 0.71-0.86), with a similar benefit for both alosetron and cilansetron. Tegaserod was also superior to placebo (RR=0.85; 95% CI: 0.80-0.90). Renzapride and cisapride had no benefit in IBS.CONCLUSIONS:Alosetron, cilansetron, and tegaserod are all effective in the treatment of IBS. Serious adverse events were rare in the eligible RCTs included in this systematic review.Am J Gastroenterol advance online publication, 26 May 2009; doi:10.1038/ajg.2009.223.

PMID: 19471254 [PubMed - as supplied by publisher]

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