On‐demand treatment with alverine citrate/simeticone compared with standard treatments for irritable bowel syndrome: results of a randomised pragmatic study. Issue 2 (21st October 2013)

• Record Type: Journal Article
• Authors: Ducrotte, P.; Grimaud, J. C.; Dapoigny, M.; Personnic, S.; O'Mahony, V.; Andro‐Delestrain, M. C.
• Is Part Of: International journal of clinical practice. Volume 68:Issue 2(2014)
• Page Start: 245
• Page End: 254
• Publication Date: 2013-10-21
• Subjects: Clinical medicine -- Periodicals; Medicine -- Periodicals; 610.5
• DOI: 10.1111/ijcp.12333
• Languages: English
• ISSNs: 1368-5031

Abstract

<abstract abstract-type="main" id="ijcp12333-abs-0001"> <title>Summary</title> <sec id="ijcp12333-sec-0001" sec-type="section"> <title>Background</title> <p>In routine practice, irritable bowel syndrome (IBS) symptoms are often difficult to be relieved and impair significantly patients' quality of life (QoL). A randomised, double‐blind, placebo‐controlled study has shown the efficacy of alverine citrate/simeticone (ACS) combination for IBS symptom relief.</p> </sec> <sec id="ijcp12333-sec-0002" sec-type="section"> <title>Aim</title> <p>As IBS symptoms are often intermittent, this pragmatic study was designed to compare the efficacy of an on‐demand ACS treatment vs. that of usual treatments.</p> </sec> <sec id="ijcp12333-sec-0003" sec-type="section"> <title>Methods</title> <p>Rome III IBS patients were enrolled by 87 general practitioners who were randomly allocated to one of two therapeutic strategies: on‐demand ACS or usual treatment chosen by the physician. The primary outcome measure was the improvement of the IBSQoL score between inclusion and month 6.</p> </sec> <sec id="ijcp12333-sec-0004" sec-type="section"> <title>Results</title> <p>A total of 436 patients (mean age: 54.4 years; women: 73.4%) were included, 222 in the ACS arm and 214 patients in the usual treatment arm, which was mainly antispasmodics. At 6 months, improvement of IBSQoL was greater with ACS than with the usual treatment group (13.8 vs. 8.4; p < 0.0008). The IBS‐severity symptom score (IBS‐SSS) was lower with ACS than in the usual treatment arm with a mean (SE) decrease of 170.0 (6.6) vs. 110.7 (6.7), respectively (p = 0.0001). An IBS‐SSS < 75 was more frequent in the ACS group (37.7% vs. 16.0%; p < 0.0001). Improvement of both abdominal pain and bloating severity was also greater with the on‐demand ACS treatment, which was associated with both lower direct and indirect costs.</p> </sec> <sec id="ijcp12333-sec-0005" sec-type="section"> <title>Conclusions</title> <p>After 6 months, on‐demand ACS treatment led to a greater improvement of QoL, reduced the burden of the disease and was more effective for IBS symptom relief than usual treatments.</p> </sec> </abstract>