Laboratories Almirall S.A., Barcelona, Spain.
J Med Econ. 2013;16(3):329-41. doi: 10.3111/13696998.2012.756397. Epub 2012 Dec 14.
To conduct a systematic literature review to assess burden of disease and unmet medical needs in patients with irritable bowel syndrome (IBS) with constipation (IBS-C), with a focus on five European countries (France, Germany, Italy, Spain, UK).
MEDLINE, EMBASE, and grey literature searches were carried out using terms for IBS and constipation, to identify studies reporting epidemiological, clinical, humanistic, or economic outcomes for IBS-C, published between 2000 and 2010.
Searches identified 885 unique abstracts and 33 supplementary articles, of which 100 publications and six grey literature sources met the inclusion criteria. Among patients with IBS, the prevalence estimates of IBS-C ranged from 1 to 44%. Co-morbid conditions, such as personality traits, psychological distress, and stress, were common. Patients with IBS-C had lower health-related quality-of-life (HRQoL) compared with the general population, and clinical trials suggested that effectively treating IBS-C improves HRQoL. The European societal cost of IBS-C is largely unknown, as no IBS-C-specific European cost-of-illness studies were identified. Two cost analyses demonstrated the substantial societal impact of IBS-C, including reduced productivity at work and work absenteeism. Guidelines offered similar recommendations for the diagnosis and management of IBS; however, recommendations specifically for IBS-C varied by country. Current IBS-C treatment options have limited efficacy and the risk:benefit profile of early 5-HT(4) agonists restricts clinical use.
This systematic review indicates a clear need for European-focused IBS-C burden-of-disease and cost-of-illness studies to address identified evidence gaps. There is a need for new therapies for IBS-C that are effective, well tolerated, and have a positive impact on HRQoL.
系统评价欧洲五个国家（法国、德国、意大利、西班牙和英国）中便秘型肠易激综合征（IBS-C）患者的疾病负担和未满足的医疗需求。
使用 IBS 和便秘的术语，对 MEDLINE、EMBASE 和灰色文献进行检索，以确定报告 IBS-C 的流行病学、临床、人文和经济学结局的研究，检索时间范围为 2000 年至 2010 年。
检索共识别出 885 篇摘要和 33 篇补充文章，其中 100 篇出版物和 6 篇灰色文献符合纳入标准。在 IBS 患者中，IBS-C 的患病率估计值为 1%至 44%。常见共病，如人格特质、心理困扰和压力。与一般人群相比，IBS-C 患者的健康相关生活质量（HRQoL）较低，临床试验表明有效治疗 IBS-C 可改善 HRQoL。IBS-C 的欧洲社会成本尚不清楚，因为未确定专门针对 IBS-C 的欧洲疾病成本研究。两项成本分析表明 IBS-C 对社会造成了重大影响，包括工作生产力降低和旷工。指南为 IBS 的诊断和管理提供了相似的建议；然而，各国的建议有所不同。目前的 IBS-C 治疗选择疗效有限，早期 5-HT(4)激动剂的风险效益比限制了其临床应用。
本系统评价表明，需要进行以欧洲为重点的 IBS-C 疾病负担和疾病成本研究，以解决已确定的证据差距。需要新的治疗方法来治疗 IBS-C，这些方法应具有疗效、良好的耐受性并对 HRQoL 产生积极影响。
