Martinez de Andino Nicole
Division of Gastroenterology/Hepatology, Department of Internal Medicine, Medical College of Georgia, Augusta University, Augusta, Georgia.
J Am Assoc Nurse Pract. 2018 Jul;30(7):412-420. doi: 10.1097/JXX.0000000000000090.
Chronic idiopathic constipation (CIC) is a prevalent disorder affecting productivity, quality of life, and health care resource utilization. Nurse practitioners (NPs) play a critical function in managing patients presenting with CIC, with roles including evaluation, diagnosis, treatment decisions, and patient education. For adults with inadequate response or tolerability issues using over-the-counter treatments, three prescription agents (plecanatide, linaclotide, and lubiprostone) are available in the United States to treat CIC, of which plecanatide was mostly recently approved. This review provides NPs with a current overview and summary of plecanatide in the current treatment landscape for CIC.
PubMed was searched for the literature regarding clinical practice guidelines and published trial data for lubiprostone, linaclotide, and plecanatide in CIC.
Efficacy and safety comparisons between prescription agents are limited beacause of the differences in trial duration and primary end points (all different). Generally, plecanatide and linaclotide demonstrated similar efficacy, with plecanatide demonstrating lower rates of adverse events.
The success of CIC treatment can be affected by patient adherence to the regimen, which is dependent on the efficacy and tolerability of treatment. Plecanatide is a promising option for patients whose CIC symptoms are not adequately controlled using their current treatment approach.
慢性特发性便秘（CIC）是一种常见疾病，会影响工作效率、生活质量及医疗资源利用。执业护士（NPs）在管理CIC患者方面发挥着关键作用，其职责包括评估、诊断、治疗决策及患者教育。对于使用非处方治疗效果不佳或存在耐受性问题的成人，美国有三种处方药（普卡那肽、利那洛肽和鲁比前列酮）可用于治疗CIC，其中普卡那肽是最近才获批的。本综述为执业护士提供了普卡那肽在CIC当前治疗格局中的最新概述和总结。
在PubMed上检索有关CIC中鲁比前列酮、利那洛肽和普卡那肽的临床实践指南及已发表试验数据的文献。
由于试验持续时间和主要终点不同（均有差异），处方药之间的疗效和安全性比较有限。一般来说，普卡那肽和利那洛肽疗效相似，但普卡那肽不良事件发生率较低。
CIC治疗的成功可能会受到患者对治疗方案依从性的影响，而这又取决于治疗的疗效和耐受性。对于当前治疗方法无法充分控制CIC症状的患者，普卡那肽是一个有前景的选择。
