@article{052f2a42ca61440e8ba092f30e9f3099,
title = "Current US Food and Drug Administration-Approved Pharmacologic Therapies for the Treatment of Irritable Bowel Syndrome with Diarrhea",
abstract = "Irritable bowel syndrome (IBS) is a functional bowel disorder characterized by abdominal pain and alterations in stool form and/or frequency, leading to reduced quality of life. Pharmacologic agents currently approved by the US Food and Drug Administration for treatment of IBS with diarrhea (IBS-D) in adults are the nonsystemic antibiotic rifaximin, the mixed µ- and κ-opioid receptor agonist/δ-opioid antagonist eluxadoline, and the selective serotonin 5-HT3 antagonist alosetron (the last of which is indicated only in women with severe IBS-D refractory to conventional therapy). Both eluxadoline and alosetron are administered as chronic daily therapies; rifaximin is given as a 2-week course of treatment with repeat courses administered as needed for symptom recurrence. Presumed mechanisms of action of rifaximin include modulation of the gut microbiota, anti-inflammatory activity, normalization of visceral hypersensitivity, and reduction in intestinal permeability. Eluxadoline targets opioid receptors in the gastrointestinal (GI) tract, resulting in decreased GI motility, fluid secretion, and visceral pain perception. Alosetron antagonizes serotonergic afferent neural signals and also slows GI motility. The efficacy and safety of these agents have been investigated in several rigorous clinical trials, and it has been demonstrated that they improve global and individual IBS symptoms. This review highlights the pivotal efficacy and safety data of the three pharmacologic agents currently indicated in the USA for the management of IBS-D in adults. Funding: Salix Pharmaceuticals.",
keywords = "Alosetron, Diarrhea, Eluxadoline, Irritable bowel syndrome, Rifaximin",
author = "Brenner, {Darren M.} and Sayuk, {Gregory S.}",
note = "Funding Information: Technical editorial and medical writing assistance was provided, under direction of the authors, by Sophie Bolick, Ph.D., and Sujata Swaminathan, Ph.D., Synchrony Medical Communications, LLC, West Chester, PA. Funding for this support was provided by Salix Pharmaceuticals, Bridgewater, NJ. Funding Information: Salix Pharmaceuticals provided funding for technical editorial and medical writing assistance for this review, in addition to the journal?s fee for open access publication. Technical editorial and medical writing assistance was provided, under direction of the authors, by Sophie Bolick, Ph.D., and Sujata Swaminathan, Ph.D., Synchrony Medical Communications, LLC, West Chester, PA. Funding for this support was provided by Salix Pharmaceuticals, Bridgewater, NJ. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published. Darren M. Brenner has served as a consultant, advisor, and speaker for Salix, Synergy Pharmaceuticals, Allergan, Ironwood Pharmaceuticals, Shire, The GI Health Foundation, Medscape, and Pri-Med. Gregory S. Sayuk has served as a consultant for Synergy, Allergan, and Ironwood Pharmaceuticals; and as a speaker for Salix, Synergy, Allergan, and Ironwood Pharmaceuticals. This article is a review and based on previously published studies. The review does not contain any new studies with human participants or animals. Data sharing is not applicable to this article, as no datasets were generated or analyzed during the current review. Publisher Copyright: {\textcopyright} 2019, The Author(s).",
year = "2020",
month = jan,
day = "1",
doi = "10.1007/s12325-019-01116-z",
language = "English",
volume = "37",
pages = "83--96",
journal = "Advances in Therapy",
issn = "0741-238X",
number = "1",
}