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Medline ® Abstract for Reference 44

of 'Management of chronic constipation in adults'

A double-blind, placebo-controlled study of prucalopride in elderly patients with chronic constipation.
Müller-Lissner S, Rykx A, Kerstens R, Vandeplassche L
Neurogastroenterol Motil. 2010;22(9):991.
BACKGROUND: Constipation affects up to 50% of the elderly; this study evaluates the efficacy, safety, and tolerability of the selective 5-HT(4) agonist prucalopride in chronically constipated elderly patients.
METHODS: Three hundred chronic constipation patients aged>or=65 years were randomized to prucalopride (1, 2, or 4 mg once daily) or placebo for 4 weeks. The primary endpoint was the percentage of patients with>or=3 spontaneous complete bowel movements (SCBM) per week. Secondary endpoints included the percentage with an increase of>or=1 SCBM per week, BM frequency, constipation-related symptoms, quality of life (QoL), safety, and tolerability.
KEY RESULTS: More patients achieved>or=3 SCBM per week with prucalopride than with placebo. This difference was largest and significant during the first week of 4 mg prucalopride (P<or= 0.05). Significantly more patients in each prucalopride group achieved an increase of>or=1 SCBM per week from baseline vs placebo (e.g. 60% with 1 mg prucalopride vs 34% with placebo at week 4; P<or= 0.05). More patients had improvement in PAC-QOL satisfaction score of>or=1 with1 mg prucalopride than with placebo (P<or= 0.05); the same was true for PAC-SYM stool symptoms (1 and 4 mg prucalopride; P<or= 0.05). Treatment-emergent adverse events were similar between groups: the most frequently reported with prucalopride were headache and gastrointestinal events. There were no clinically significant differences between prucalopride and placebo for vital signs, laboratory assessments, or ECG variables.
CONCLUSIONS&#38; INFERENCES: Prucalopride, in the dose-range tested (1-4 mg once daily), has beneficial effects on bowel movements, symptoms, and QoL, and is safe and well-tolerated in elderly patients with chronic constipation.
Park-Klinik Weissensee, Berlin, Germany. mueli@park-klinik.com