Comparative Efficacy and Safety of Lubiprostone and Osmotic Laxatives in Chronic Idiopathic Constipation: A Systematic Review and Network Meta‐Analysis

Yang, Luoyao; Zong, Ye; Meng, Fandong; Wu, Yongdong; Zhang, Shutian

doi:10.1111/jgh.16844

Cited by 5Gastrointestinal motility and disordersPelvic floor disorders treatmentsGastroesophageal reflux and treatments

Comparative Efficacy and Safety of Lubiprostone and Osmotic Laxatives in Chronic Idiopathic Constipation: A Systematic Review and Network Meta‐Analysis

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Yang, Luoyao, Zong, Ye, Meng, Fandong, Wu, Yongdong, Zhang, Shutian·2025·Journal of Gastroenterology and Hepatology

DOI 10.1111/jgh.16844

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Abstract

Objective: The objective of this study is to compare the efficacy and safety of lubiprostone (Lub) with osmotic laxatives in the treatment of chronic idiopathic constipation (CIC). Methods: A comprehensive literature search was conducted using PubMed, EMBASE, and the Cochrane Library in May 2024. Studies that met the inclusion criteria were manually searched by two independent reviewers. The efficacy was assessed by the proportion of patients with spontaneous bowel movements (SBMs) within 24 h after the first administration of the medication and SBMs in Weeks 1 and 4. Safety was evaluated based on adverse events including nausea, diarrhea, and abdominal distension. Optimal probability values and the surface under the cumulative ranking area (SUCRA) were also calculated for all interventions. Higher SUCRA values indicate better efficacy and safety of the intervention. Results: Following a thorough search and screening process, 25 articles were included. Among the selected trials, 8 compared Lub to placebo, 10 compared polyethylene glycol (PEG) to placebo, 4 compared lactulose (Lac) to placebo, and 3 compared PEG to Lac. The meta‐analysis results indicated that Lub and osmotic laxatives were significantly more effective than placebo. According to the SUCRA results, the highest rank probabilities were for Lub in increasing the SBMs and reducing abdominal distension. Conclusion: Lubiprostone is more effective than PEG and Lactulose for treating CIC, with comparable safety profiles. However, this conclusion requires further validation through large‐scale, high‐quality studies.

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The only treatment-related serious adverse events (1% of all children) in the lubiprostone-treated group were single cases of hypersensitivity reaction, rash, and chest pain.
“The only treatment‐related serious adverse events (1% of all children) reported in the lubiprostone‐treated group were single cases of hypersensitivity reaction, rash, and chest pain. 76”
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E. Coss-Adame, J. M. Remes-Troche, R. Flores Rendón, J. L. Tamayo de la Cuesta, and M. A. Valdovinos Díaz, "Efficacy and Safety of Lubi- prostone for the Treatment of Chronic Idiopathic Constipation: A Phase 3, Randomized, Placebo-Controlled Study," Revista de Gastroenterolo- gia de Mexico (English) 89 (2024): 70-79.

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European Society for Paediatric Gastroenterology, Hepatology and Nutrition/North American Society for Pediatric Gastroenterology, Hepatology and Nutrition guidelines for treatment of functional constipation in children aged 0–18 years
Gordon, M., de Geus, A., Boruta, M., Banasiuk, M., Benninga, M., Borrelli, O., Darbari, A., Dore‐Stites, D., Gould, M., Hawa, J., et al. (2026) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1002/jpn3.70447 · Cited by 4 · see citing works

Authors: Yang, L., Zong, Y., Meng, F., Wu, Y., & Zhang, S.
Affiliations: Capital Medical University (CN)
Corresponding author: Wu, Yongdong
ORCID: Yang, Luoyao
Zong, Ye
Meng, Fandong
Wu, Yongdong
Zhang, Shutian
Venue: Journal of Gastroenterology and Hepatology
Publisher: Wiley
Published: 2024-12-11
Volume: 40
Issue: 2
Pages: 387-397
ISSN: 0815-9319 (ISSN-L)
1440-1746
DOI: 10.1111/jgh.16844
OpenAlex: W4405281985
Cited by: 5
References: 51
Citations by year: 2026: 1 · 2025: 4
FWCI: 0.51
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Journal of Gastroenterology and Hepatology (publishedVersion)
PubMed (publishedVersion)
Funders: National Basic Research Program of China (2023YFC2507300)
Topics: Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
Health Sciences › Medicine › Gastroenterology › Gastroesophageal reflux and treatments
Keywords: lubiprostone, osmotic laxatives, chronic idiopathic constipation, polyethylene glycol, lactulose, spontaneous bowel movements, abdominal distension, drug efficacy, drug safety, adverse events
MeSH terms: Lubiprostone, Network Meta-Analysis as Topic, Chronic Disease, Constipation, Defecation, Humans, Lactulose, Osmosis, Polyethylene Glycols, Treatment Outcome, Laxatives

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Comparative Efficacy and Safety of Lubiprostone and Osmotic Laxatives in Chronic Idiopathic Constipation: A Systematic Review and Network Meta‐Analysis

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