Factors associated with long-term efficacy of lubiprostone for chronic constipation

抄録

The prevalence of chronic constipation in Japan is increasing, and is presently almost 1 in 5 people. Because constipation is common, especially in older patients, to avoid adverse events and poly­pharmacy, simple treatments at low doses are generally desired. Although the chloride channel activator lubiprostone is candidate drug that may solve these problems, factors associated with the long-term efficacy of lubiprostone monotherapy for chronic constipation in treatment-naive patients remain unclear. We here retrospectively investigated the clinical characteristics and factors of patients who achieved long-term constipation improvement with lubiprostone monotherapy. Seventy-four patients with chronic constipation treated with lubiprostone monotherapy (24 or 48 ‍μg/day) from January 2017 to August 2018 were reviewed. Patient characteristics and clinical time-courses were compared between those who sustained improvement for 6 months, and ‍those who became refractory to treatment. In 54 patients (76.1%), constipation improved by lubiprostone administration for 6 months. On multivariate analysis, a significant clinical factor ‍associated with sustained improvement was a starting lubiprostone dose of 24 ‍μg/day (odds ratio: 5.791; 95% confidence interval: 1.032–32.498; p = 0.046). A starting lubiprostone dose of 24 ‍μg/day has efficacy to improve chronic constipation and to prevent adverse events of nausea and diarrhea in Japanese patients.