Summary

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• This summary is based on the review of one systematic review/meta-analysis. ^[1]
• Bisacodyl showed the greatest efficacy in increasing spontaneous bowel movements (SBMs) and complete SBMs (CSBMs), with a maximal increase of 6.8 SBMs per week (95% confidence interval (CI) 6.1-7.6) and 4.7 CSBMs per week (95% CI 4.3-5.1), although efficacy decreased by week 4.
• Prucalopride ranked highest at 12 weeks for reducing failure to achieve three or more CSBMs per week (relative risk (RR) 0.82, 95% CI 0.78-0.86) and for increasing CSBMs by one or more per week (RR 0.74, 95% CI 0.66-0.83), maintaining longer-term efficacy compared to bisacodyl.
• Linaclotide and Prucalopride showed comparable effectiveness at 12 weeks, with similar P-scores for achieving CSBMs, while bisacodyl was more effective in the short term (4 weeks).
• Bisacodyl had the highest incidence of adverse events and abdominal pain compared to other drugs, with a P-score of 0.08 for total adverse events.
• Comparative Safety: Bisacodyl ranked last in safety compared to other treatments, showing a significantly higher occurrence of adverse events, particularly abdominal pain.
• Patients with chronic idiopathic constipation, including those who previously did not respond to laxatives, experienced significant benefits from Prucalopride, which was particularly effective in increasing CSBMs in these refractory cases. Bisacodyl and sodium picosulfate also showed short-term efficacy in a broader range of patients, including those with milder symptoms.