Efficacy and Safety of Selective Calcium Channel Blockers for Irritable Bowel Syndrome:A Meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 CHENXue-e ,  WANGCheng-dang

Department of Gastroenterology, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China;

Corresponding author：

WANGCheng-dang, Email: wangcdhl@sina.com

Keywords：

Irritable bowel syndrome (IBS); Selective calcium channel blocker; Pinaverium bromide; Otilonium bromide; Meta-analysis; Systematic review; Randomized controlled trial

DOI：

10.7507/1672-2531.20150142

Video：

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Objective To systematically review the efficacy and safety of selective calcium channel blockers (SCCBs) versus placebo for irritable bowel syndrome (IBS) patients. Methods We searched databases including PubMed, EMbase, the Cochrane Library, CBM, WanFang Data, VIP and CNKI for relevant randomized controlled trials (RCTs) of SCCB versus placebo for IBS patients from inception to August, 2013. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the risk of bias of included studies. Then, meta-analysis was performed by RevMan 5.3 software. Results A total of 12 RCTs involving 1 325 patients were included. The results of meta-analysis showed that: The total effective rate (RR=2.06, 95%CI 1.56 to 2.73, P<0.000 01, NNT=3), abdominal pain remission rate (RR=1.47, 95%CI 1.31 to 1.65, P<0.000 01, NNT=5), and abdominal distension remission rate (RR=1.48, 95%CI 1.10 to 2.00, P=0.01, NNT=5) in the SCCB group were significantly higher than those in the placebo group. The adverse reaction rate of the SCCB group was also significantly higher than that of the placebo group (RD=3%, 95%CI 2% to 4%, P=0.002), but all adverse reactions of the SCCB group were minor. Subgroup analysis based on different SCCBs showed that there were no significant differences between the otilonium bromide subgroup and the pinaverium bromide subgroup in above outcomes (all P values >0.05). Conclusion Current evidence shows that SCCBs can improve the symptoms of IBS with minor side-effects. Due to limited quality and quantity of included studies, more large-scale high-quality studies are needed to verify the above conclusion.

Citation： CHENXue-e, WANGCheng-dang. Efficacy and Safety of Selective Calcium Channel Blockers for Irritable Bowel Syndrome:A Meta-analysis. Chinese Journal of Evidence-Based Medicine, 2015, 15(7): 840-846. doi: 10.7507/1672-2531.20150142 Copy

1.	Krogsgaard LR,Engsbro AL,Bytzer P.The epidemiology of irritable bowel syndrome in Denmark.A population-based survey in adults 50 years of age.Scand J Gastroenterol,2013,48(5):523-529.
2.	Manning AP,Thompson WG,Heaton KW,et al.Towards positive diagnosis of the irritable bowel syndrome.Br Med J,1978,2(6138):653-654.
3.	Saito YA,Locke GR,Talley NJ,et al.A comparison of the Rome and Manning criteria for case identification in epidemiological investigations of irritable bowel syndrome.Am J Gastroenterol,2000,95(10):2816-2824.
4.	Thompson WG,Longstreth GF,Drossman DA,et al.Functional bowel disorders and functional abdominal pain.Gut,1999,45(2):Ⅱ43-Ⅱ47.
5.	Drossman DA.The functional gastrointestinal disorders and the Rome Ⅲ process.Gastroenterology,2006,130(5):1377-1390.
6.	刘鸣.系统评价、Meta-分析设计与实施方法.北京:人民卫生出版社,2011:69-71.
7.	Levy C,Charbonnier A,Cachin M.Pinaverium bromide and functional disease (double blind study).Sem Hop Ther,1977,53(7-8):372-374.
8.	Delmont J.1nteretdel'adjonctiond'un antispasmodique musculotrope autraitement des constipations douloureuses des colopathies fonctionnelles par le son.Med Chir Dig,1981,4(43):365-370.
9.	Baldi F,Corinaldesi R.Ferrarini F,et al.Clinical and functional evaluation of octilonium bromide in the treatment of irritable bowel syndrome:A double blind controlled trial.Clin Trials J,1983,20:77-88.
10.	Awad R,Dibildox M,Ortiz F.Irritable bowel syndrome treatment using observation on the efficacy of as a calcium channel blocker.A randomized double b1ind placebo-controlled trial.Acta Gastroenterol Latinoam,1995,25(3):137-144.
11.	Battaglia G,Morselli-Labate AM,Camarri E,et al.Otilonium bromide in irritable bowel syndrome:a double-blind,placebo-controlled,15-week study.Aliment Pharmacol Ther,1998,12(10):1003-1010.
12.	Clavé P,Acalovschi M,Triantafillidis JK,et al.Randomised clinical trial:otilonium bromide improves frequency of abdominal pain,severity of distention and time to relapse in patients with irritable bowel syndrome.Aliment Pharmacol Ther,2011,34(4):432-442.
13.	王德标,崔美华.匹维溴胺治疗肠易激综合征临床分析.江苏药学与临床研究,2000,8(4):27-28.
14.	黄咏梅,张淑秀,娄蓓,等.奥替溴铵治疗肠易激综合征短期疗效评价.胃肠病学和肝病学杂志,2001,10(2):192-193.
15.	赵德光,王刚,武兴东.匹维溴铵治疗肠易激综合征30例.中国煤炭工业医学杂志,2004,7(5):467.
16.	王琴,黄庆娟,王菲,等.洁白胶囊与匹维溴铵治疗腹泻型肠易激综合征疗效对比研究.实用临床医学,2006,7(10):18-20.
17.	张竹,李文兵,徐梦军.匹维溴铵治疗肠易激综合征的临床观察.当代医学,2011,17(11):140-141.
18.	张竹,李文兵,徐梦军.匹维溴铵治疗肠易激综合征的疗效分析与评价.临床合理用药杂志,2011,4(10X):43-45.
19.	Tillisch K,Labus JS,Naliboff BD,et al.Characterization of the alternating bowel habit subtype in patients with irritable bowel syndrome.Am J Gastroenterol,2005,100(4):896-904.
20.	JK Triantafillidis,G Malgarinos.Long-term efficacy and safety of otilonium bromide in the management of irritable bowel syndrome:a literature review.Clin Exp Gastroenterol,2014,7(22):75-82.
21.	Poynard T,Regimbeau C,Benhamou Y.Meta-analysis of smooth muscle relaxants in the treatment of irritable bowel syndrome.Aliment Pharmacol Ther,2001,15(3):355-361.
22.	Ruepert L,Quartero AO,de Wit NJ,et al.Bulking agents,antispasmodics and antidepressants for the treatment of irritable bowel syndrome.Cochrane Database Syst Rev,2011,(8):CD003460.
23.	赵鹏程,王一平,潘涛.选择性钙通道拮抗剂治疗肠易激综合征的系统评价.中国循证医学杂志,2004,4(3):167-172.

1. Krogsgaard LR,Engsbro AL,Bytzer P.The epidemiology of irritable bowel syndrome in Denmark.A population-based survey in adults 50 years of age.Scand J Gastroenterol,2013,48(5):523-529.
2. Manning AP,Thompson WG,Heaton KW,et al.Towards positive diagnosis of the irritable bowel syndrome.Br Med J,1978,2(6138):653-654.
3. Saito YA,Locke GR,Talley NJ,et al.A comparison of the Rome and Manning criteria for case identification in epidemiological investigations of irritable bowel syndrome.Am J Gastroenterol,2000,95(10):2816-2824.
4. Thompson WG,Longstreth GF,Drossman DA,et al.Functional bowel disorders and functional abdominal pain.Gut,1999,45(2):Ⅱ43-Ⅱ47.
5. Drossman DA.The functional gastrointestinal disorders and the Rome Ⅲ process.Gastroenterology,2006,130(5):1377-1390.
6. 刘鸣.系统评价、Meta-分析设计与实施方法.北京:人民卫生出版社,2011:69-71.
7. Levy C,Charbonnier A,Cachin M.Pinaverium bromide and functional disease (double blind study).Sem Hop Ther,1977,53(7-8):372-374.
8. Delmont J.1nteretdel'adjonctiond'un antispasmodique musculotrope autraitement des constipations douloureuses des colopathies fonctionnelles par le son.Med Chir Dig,1981,4(43):365-370.
9. Baldi F,Corinaldesi R.Ferrarini F,et al.Clinical and functional evaluation of octilonium bromide in the treatment of irritable bowel syndrome:A double blind controlled trial.Clin Trials J,1983,20:77-88.
10. Awad R,Dibildox M,Ortiz F.Irritable bowel syndrome treatment using observation on the efficacy of as a calcium channel blocker.A randomized double b1ind placebo-controlled trial.Acta Gastroenterol Latinoam,1995,25(3):137-144.
11. Battaglia G,Morselli-Labate AM,Camarri E,et al.Otilonium bromide in irritable bowel syndrome:a double-blind,placebo-controlled,15-week study.Aliment Pharmacol Ther,1998,12(10):1003-1010.
12. Clavé P,Acalovschi M,Triantafillidis JK,et al.Randomised clinical trial:otilonium bromide improves frequency of abdominal pain,severity of distention and time to relapse in patients with irritable bowel syndrome.Aliment Pharmacol Ther,2011,34(4):432-442.
13. 王德标,崔美华.匹维溴胺治疗肠易激综合征临床分析.江苏药学与临床研究,2000,8(4):27-28.
14. 黄咏梅,张淑秀,娄蓓,等.奥替溴铵治疗肠易激综合征短期疗效评价.胃肠病学和肝病学杂志,2001,10(2):192-193.
15. 赵德光,王刚,武兴东.匹维溴铵治疗肠易激综合征30例.中国煤炭工业医学杂志,2004,7(5):467.
16. 王琴,黄庆娟,王菲,等.洁白胶囊与匹维溴铵治疗腹泻型肠易激综合征疗效对比研究.实用临床医学,2006,7(10):18-20.
17. 张竹,李文兵,徐梦军.匹维溴铵治疗肠易激综合征的临床观察.当代医学,2011,17(11):140-141.
18. 张竹,李文兵,徐梦军.匹维溴铵治疗肠易激综合征的疗效分析与评价.临床合理用药杂志,2011,4(10X):43-45.
19. Tillisch K,Labus JS,Naliboff BD,et al.Characterization of the alternating bowel habit subtype in patients with irritable bowel syndrome.Am J Gastroenterol,2005,100(4):896-904.
20. JK Triantafillidis,G Malgarinos.Long-term efficacy and safety of otilonium bromide in the management of irritable bowel syndrome:a literature review.Clin Exp Gastroenterol,2014,7(22):75-82.
21. Poynard T,Regimbeau C,Benhamou Y.Meta-analysis of smooth muscle relaxants in the treatment of irritable bowel syndrome.Aliment Pharmacol Ther,2001,15(3):355-361.
22. Ruepert L,Quartero AO,de Wit NJ,et al.Bulking agents,antispasmodics and antidepressants for the treatment of irritable bowel syndrome.Cochrane Database Syst Rev,2011,(8):CD003460.
23. 赵鹏程,王一平,潘涛.选择性钙通道拮抗剂治疗肠易激综合征的系统评价.中国循证医学杂志,2004,4(3):167-172.

Chinese Journal of Evidence-Based Medicine

Efficacy and Safety of Selective Calcium Channel Blockers for Irritable Bowel Syndrome:A Meta-analysis

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