Elobixibat 10 mg significantly improves bowel movement and stool consistency in chronic constipation patients

Chronic constipation (CC) is a prevalent gastrointestinal disorder, often exacerbated by common incretin-based anti-obesity therapies, leading to adherence issues. Traditional laxatives, while effective, are associated with concerning adverse events like melanosis coli and colonic neuromuscular disorder with long-term use. This creates a critical need for safer, more tolerable alternatives. Elobixibat, an ileal bile acid transporter (IBAT) inhibitor, offers a novel mechanism by increasing bile acid delivery to the colon, thereby promoting colonic motility and fluid secretion, presenting a promising solution to address these challenges.

This systematic review and meta-analysis synthesized data from six randomized controlled trials (RCTs) to evaluate the efficacy and safety of elobixibat 10 mg compared to placebo. Researchers included studies involving patients with functional chronic constipation. The search spanned PubMed/MEDLINE, ScienceDirect, and Cochrane Database of Systematic Reviews. Study quality was assessed using the Cochrane risk of bias 2.0 tool, and statistical analyses were performed with RevMan 5.4.1 software, focusing on primary endpoints like spontaneous bowel movement (SBM) and complete spontaneous bowel movement (CSBM).

Elobixibat demonstrated marked improvements in bowel movement parameters across the included RCTs.

Elobixibat significantly improved spontaneous bowel movement (SBM) with a mean difference (MD) of 2.91 (95% CI 2.81 to 3.01, p<0.00001). Complete spontaneous bowel movement (CSBM) also saw a significant improvement with an MD of 0.61 (95% CI 0.38 to 0.83, p<0.00001). The percentage of patients experiencing their first SBM within 24 hours was significantly higher in the elobixibat group, showing a relative risk (RR) of 1.49 (95% CI 1.21 to 1.84, p=0.0002). Furthermore, stool consistency, a key indicator of constipation relief, improved significantly in the elobixibat group (MD 1.40, 95% CI 1.09 to 1.71, p<0.00001). Importantly, the elobixibat group reported favorable safety profiles with no serious adverse events, indicating good tolerability.