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肠吸附剂Silicol®凝胶治疗成人腹泻型或混合型肠易激综合征的疗效:观察性开放标签研究

Efficacy of the Enteroadsorbent Silicol®gel in Adults with Irritable Bowel Syndrome Subtypes IBS-D or Mixed: Observational Open-Label Study.

作者信息

Crawford Gordon, Taylor Rory, Young David, Hatton Chris G

机构信息

CPS Research, McCafferty House, 99 Firhill Road, Glasgow, UK G20 7BE.

Department of Mathematics and Statistics, University of Strathclyde, 26 Richmond Street, Glasgow, UK G1 1XH.

出版信息

Gastroenterol Res Pract. 2023 Dec 16;2023:3432763. doi: 10.1155/2023/3432763. eCollection 2023.

Abstract

BACKGROUND

Irritable bowel syndrome (IBS) is a common chronic gut-brain interaction disorder with limited effective treatment options. Intestinal adsorbents have a high adsorption capacity for gut irritants and may provide nonpharmacological alternatives.

OBJECTIVES

This post marketing study is aimed at providing up-to-date evidence to support the safety and efficacy in normal use of an established medical device for IBS treatment.

METHODS

In this open-label, observational study, adults with IBS with predominant diarrhoea (IBS-D) or IBS with mixed bowel habits (IBS-M), according to Rome IV criteria, received 4 weeks of treatment with the enteroadsorbent Silicol®gel, a CE-certified, licenced, medical device containing colloidal silicic acid. Eligible participants were assessed at baseline (visit 1; in-clinic) and after 1 (visit 2; telephone), 2 (visit 3; telephone), and 4 (visit 4; in-clinic) weeks of treatment. The primary endpoint was the proportion of participants with an overall reduction in the IBS severity scoring system (IBS SSS) > 50, representing clinically meaningful improvement. Key secondary endpoints were a reduction in common IBS symptoms and improved quality of life (QoL).

RESULTS

Among the 67 treated participants (IBS-D: 37; IBS-M: 30), 65 completed the study. At visit 4, 83.6% (56/67) of participants achieved a reduction in IBS SSS > 50. The mean (standard deviation [SD]) IBS SSS was 323.4 (55.7) at visit 1 and 160.3 (90.3) at visit 4 (overall change: -163.1 (101.7); 95% confidence interval [CI] 138.3, 187.9, < 0.001). Compared with visit 1, significant reductions in the severity of all key IBS symptoms and overall improvement in QoL were observed at visit 4 ( < 0.001), with improvements observed from visits 1 and 2.

CONCLUSIONS

In this open-label study of participants with IBS-D and IBS-M, Silicol®gel provided clinically significant improvement in IBS symptoms, demonstrating that enteroadsorbents may be clinically beneficial in this population.

摘要

背景

肠易激综合征(IBS)是一种常见的慢性肠-脑互动障碍,有效治疗方案有限。肠道吸附剂对肠道刺激物具有高吸附能力,可能提供非药物治疗选择。

目的

这项上市后研究旨在提供最新证据,以支持一种已获认可的用于治疗IBS的医疗器械在正常使用中的安全性和有效性。

方法

在这项开放标签的观察性研究中,根据罗马IV标准,患有以腹泻为主型肠易激综合征(IBS-D)或混合型肠易激综合征(IBS-M)的成年人接受了4周的肠吸附剂Silicol®凝胶治疗,这是一种经CE认证、有许可证的含胶体硅酸的医疗器械。符合条件的参与者在基线(第1次访视;门诊)以及治疗1周(第2次访视;电话随访)、2周(第3次访视;电话随访)和4周(第4次访视;门诊)后接受评估。主要终点是肠易激综合征严重程度评分系统(IBS-SSS)总体降低>50的参与者比例,这代表具有临床意义的改善。关键次要终点是常见IBS症状的减轻和生活质量(QoL)的改善。

结果

在67名接受治疗的参与者中(IBS-D:37名;IBS-M:30名),65名完成了研究。在第4次访视时,83.6%(56/67)的参与者IBS-SSS降低>50。第1次访视时IBS-SSS的均值(标准差[SD])为323.4(55.7),第4次访视时为160.3(90.3)(总体变化:-163.1(101.7);95%置信区间[CI] 138.3,187.9,P<0.001)。与第1次访视相比,在第4次访视时观察到所有关键IBS症状的严重程度显著降低以及QoL总体改善(P<0.001),从第1次和第2次访视时就观察到了改善。

结论

在这项针对IBS-D和IBS-M参与者的开放标签研究中,Silicol®凝胶使IBS症状有了具有临床意义的改善,表明肠吸附剂可能对该人群具有临床益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/033c/11390215/d0b84e35f9ab/GRP2023-3432763.001.jpg

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