Ali Hassam, Pamarthy Rahul, Sarfraz Shiza
Internal Medicine, East Carolina University, Vidant Medical Center, Greenville, USA.
Anesthesiology, Bahawal Victoria Hospital, Quaid-E-Azam Medical College, Bahawalpur, PAK.
Cureus. 2021 Apr 5;13(4):e14306. doi: 10.7759/cureus.14306.
Prucalopride is a selective serotonin receptor agonist that can be used to treat chronic constipation. This article reviews the clinical efficacy side effects of prucalopride, assessing its role in constipation and gastroparesis. Relevant published medical literature was identified by using the search terms "constipation," "gastroparesis," and "prucalopride" from 2010 and onwards. The databases included PubMed/MEDLINE and EMBASE. Bibliographies from published literature and websites were also reviewed. Results were filtered for English language and randomized controlled trials. Out of the 18 results, abstracts were manually reviewed for studies with similar statistical methodology; eight studies were selected for constipation and two studies for gastroparesis. In two four-week trials, prucalopride showed improvement in gastric emptying and the gastroparesis cardinal symptom index over placebo, with a 1-4 mg/day dosage. In seven 12-week trials in patients with chronic constipation, oral prucalopride 2-4 mg/day was more significant than placebo to improve the number of bowel movements and symptoms. One study showed no significant bowel function differences when prucalopride was compared to placebo over 12 or 24 weeks. Prucalopride was generally well-tolerated, and the most common adverse events reported were headache, nausea, diarrhea, and abdominal pain. Further long-term and comparative data would be beneficial to show that prucalopride can be an advantageous treatment option for patients with chronic idiopathic constipation (CIC) or gastroparesis. Additionally, it would be interesting to see its effect on irritable bowel syndrome-constipation predominant, as it has some overlap with idiopathic constipation.
普芦卡必利是一种选择性5-羟色胺受体激动剂，可用于治疗慢性便秘。本文综述了普芦卡必利的临床疗效和副作用，评估其在便秘和胃轻瘫中的作用。通过使用“便秘”“胃轻瘫”和“普芦卡必利”等检索词，检索了2010年及以后发表的相关医学文献。数据库包括PubMed/MEDLINE和EMBASE。还查阅了已发表文献和网站的参考文献。结果筛选为英文和随机对照试验。在18项结果中，对统计方法相似的研究进行了摘要人工审核；选择了8项便秘研究和2项胃轻瘫研究。在两项为期四周的试验中，普芦卡必利1-4毫克/天的剂量与安慰剂相比，胃排空和胃轻瘫主要症状指数有所改善。在7项针对慢性便秘患者的为期12周的试验中，口服普芦卡必利2-4毫克/天在改善排便次数和症状方面比安慰剂更显著。一项研究表明，在12周或24周内，普芦卡必利与安慰剂相比，肠道功能无显著差异。普芦卡必利总体耐受性良好，报告的最常见不良事件为头痛、恶心、腹泻和腹痛。进一步的长期和对比数据将有助于表明普芦卡必利可能是慢性特发性便秘（CIC）或胃轻瘫患者的有利治疗选择。此外，鉴于其与特发性便秘有一些重叠，观察其对以便秘为主的肠易激综合征的影响将很有趣。
