Comparative efficacy of treatment of various clinical variants of irritable bowel syndrome in real practice
S.S. Vyalov
RUDN University, Moscow
GMS, Moscow
United Medgrup, Moscow
Aim: to study the comparative efficacy of STW 5 and trimebutine in patients with various clinical variants of irritable bowel syndrome (IBS).
Patients and Methods: 616 patients with established IBS diagnosis were included in the study. All patients were divided into subgroups, depending on the prevalence of diarrhea, constipation or their alternation in the clinical picture, as well as the chosen treatment tactics. The group with the prevalence of diarrhea (IBS-D) included 195 persons, the group with the prevalence of constipation (IBS-C) — 158 patients, 263 patients were enrolled in the group with alternation of diarrhea and constipation (IBS-M). Patients of these three groups were further divided into subgroups depending on the drug used in the treatment:
STW 5 (n = 462) or trimebutine (n = 154). The groups did not differ significantly in their demographic and clinical characteristics. The duration of treatment was 4 weeks. The primary endpoints were the proportions of patients who reported significant relief of symptoms by VAS for 4 weeks.
Results: after 4 weeks the proportion of patients with abdominal pain was significantly lower in the STW 5 subgroup than in the trimebutine subgroup (11.2% vs. 34.7% in the IBS-D group, 9.0% vs. 39.2% in the IBS-3 group, 21.2% versus 41.4% in the group of IBS-M, respectively, p <0.05). The intensity of pain after 4 weeks of therapy was also significantly lower in patients receiving STW 5. It decreased from 87.6 to 15.3 in the STW 5 subgroup (95% CI 13.2–18.1) and to 31.1 in the trimebutine subgroup (95% CI 27.4–35.6). Flatulence and bloating by the 4th week of treatment were not reported by the patients in the STW 5 subgroup or had a minimum intensity of 12.8 points (95% CI 10.6–15.3) vs 28.4 (95% CI 22.6–33.2)
in the trimebutine subgroup. The proportion of patients, who fully respond to the therapy or have significant improvements, was greater in the STW 5 subgroup (p <0.05).
Conclusion: STW 5 therapy showed higher efficacy compared with trimebutine in terms of the major clinical symptoms in patients with different IBS variants.
Key words: irritable bowel syndrome, IBS, STW 5, trimebutine.
For citation: Vyalov S.S. Comparative efficacy of treatment of various clinical variants of irritable bowel syndrome in real practice // RMJ. Medical Review. 2018. № 7(I). P. 26–32.
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