Polyethylene glycol-based laxatives for chronic constipation

We read the Article by Pavit Luthra and colleagues 1 Luthra P Camilleri M Burr NE Quigley EMM Black CJ Ford AC Efficacy of drugs in chronic idiopathic constipation: a systematic review and network meta-analysis. Lancet Gastroenterol Hepatol. 2019; 4: 831-844 Summary Full Text Full Text PDF PubMed Scopus (47) Google Scholar with great interest. Their network meta-analysis of treatments for chronic idiopathic constipation aimed to assess the efficacy of oral pharmacological therapies, of which few head-to-head studies versus active comparators have been done with a small amount of data on their real-world efficacy and safety. We have general concerns regarding the assessment of osmotic laxatives in this analysis, particularly regarding polyethylene glycol-based laxatives. Polyethylene glycol-based laxatives for chronic constipation – Authors' replyWe thank Fatma Akriche and colleagues for their comments about our network meta-analysis.1 We deal with each of their concerns below. Full-Text PDF Efficacy of drugs in chronic idiopathic constipation: a systematic review and network meta-analysisAlmost all drugs studied were superior to placebo, according to either failure to achieve three or more CSBMs per week or or failure to achieve an increase of one or more CSBM per week over baseline. Although diphenyl methane laxatives ranked first at 4 weeks, patients with milder symptoms might have been included in these trials. Prucalopride ranked first at 12 weeks, and many of the included trials recruited patients who previously did not respond to laxatives, suggesting that this drug is likely to be the most efficacious for patients with chronic idiopathic constipation. Full-Text PDF