Department of Gastroenterology, Hepatology and Nutrition, Cleveland Clinic, Digestive Disease Institute, Cleveland, Ohio, USA.
Department of Medicine, University Hospital, Cleveland, Ohio, USA.
Aliment Pharmacol Ther. 2024 Oct;60(7):855-862. doi: 10.1111/apt.18198. Epub 2024 Aug 9.
There is little information on the effectiveness of therapies for severe chronic constipation. In a phase 3 trial, we previously demonstrated that a vibrating capsule was significantly more efficacious than a placebo in chronic constipation.
To examine the effects of a vibrating capsule and placebo on symptoms and health-related quality of life (HRQoL) in patients with severe chronic constipation.
We performed a post hoc analysis of phase 3, multicentre, randomised, double-blind, and placebo-controlled 8-week clinical trial of a vibrating capsule to specifically assess outcomes among subjects who reported 0 complete spontaneous bowel movements (CSBMs) during the 2-week baseline period. We assessed effects of treatment on bowel symptoms, patient satisfaction, and HRQoL. CSBM responders were defined as subjects with increases of ≥1 or ≥2 or ≥3 weekly CSBMs (CSBM1 or CSBM2, CSBM3, respectively) over baseline for ≥6 out of 8 weeks of treatment.
The severe chronic constipation subgroup comprised 175 (56%) of the 312 subjects. Significantly more subjects with severe chronic constipation who received the vibrating capsule than those who received the placebo were CSBM1 (44.9% vs. 20.9%, p = 0.007), CSBM2 (29.2% vs. 11.6%, p = 0.004), and CSBM3 (19.10% vs 6.98%, p = 0.017) responders. Straining effort, stool consistency, patient satisfaction, and HRQoL significantly improved in the severe chronic constipation subgroup. A mild vibrating sensation was reported in 10%.
The vibrating capsule significantly improved constipation-related symptoms and HRQoL in patients with severe constipation, affirming its efficacy and safety across the spectrum of chronic constipation.
对于严重慢性便秘的治疗方法,相关信息较少。在一项 3 期临床试验中,我们之前证明了振动胶囊在慢性便秘方面明显优于安慰剂。
研究振动胶囊和安慰剂对严重慢性便秘患者症状和健康相关生活质量(HRQoL)的影响。
我们对一项 3 期、多中心、随机、双盲、安慰剂对照的 8 周临床试验进行了事后分析,该试验专门评估了在基线 2 周期间报告 0 次完全自发排便(CSBM)的受试者中,振动胶囊的治疗效果。我们评估了治疗对肠道症状、患者满意度和 HRQoL 的影响。CSBM 应答者定义为在治疗的 8 周中有 6 周或 6 周以上每周 CSBM 增加≥1 次、≥2 次或≥3 次(CSBM1 或 CSBM2、CSBM3)的患者。
严重慢性便秘亚组包括 312 名受试者中的 175 名(56%)。接受振动胶囊治疗的严重慢性便秘患者中,CSBM1(44.9% vs. 20.9%,p=0.007)、CSBM2(29.2% vs. 11.6%,p=0.004)和 CSBM3(19.1% vs. 6.98%,p=0.017)的应答者显著多于接受安慰剂的患者。在严重慢性便秘亚组中,用力排便、粪便稠度、患者满意度和 HRQoL 均显著改善。10%的患者报告有轻微的振动感。
振动胶囊显著改善了严重便秘患者的便秘相关症状和 HRQoL,证实了其在整个慢性便秘谱中的疗效和安全性。