Drug updated on 4/17/2024
| Dosage Form | Tablet (oral; 75 mg, 100 mg) |
| Drug Class | Mu-opioid receptor agonists |
| Ongoing and Completed Studies | ClinicalTrials.gov |
Indication
- For treatment of adults with irritable bowel syndrome with diarrhea (IBS-D).
Summary
- Eluxadoline (Viberzi) is used for the treatment of adults with irritable bowel syndrome with diarrhea (IBS-D).
- Four systematic reviews/meta-analyses were reviewed to gather information about eluxadoline's effectiveness and safety in treating IBS-D.
- A network meta-analysis showed that eluxadoline 100mg was as effective as antispasmodics in relieving abdominal pain associated with IBS, but it had more reported adverse events than antispasmodics which are still considered the first choice for treatment.
- Another study found that opioid receptor modulators like eluxadoline have a statistically significant beneficial effect on global symptoms of IBS and bowel movement frequency, although there was no statistical significance observed in stool consistency improvement or quality of life enhancement.
- In trials comparing licensed drugs versus placebo for both constipation-predominant IBS (IBS-C) and diarrhoea-predominant IBS (IBS-D), patients receiving placebo also reported high rates of adverse events suggesting potential nocebo effects; however, active drug use resulted in significantly higher risk of any adverse event and withdrawal due to an adverse event compared to placebo groups.
- A separate network meta-analysis ranked alosetron highest for efficacy based on composite endpoint improvements including abdominal pain relief and stool consistency among pharmacological therapies licensed for treating either type - diarrhoea predominant or mixed-stool patterned Irritable Bowel Syndrome; while rifaximin ranked first considering safety aspects despite all tested drugs being superior over placebos at 12 weeks according to FDA-recommended endpoints.
Product Monograph / Prescribing Information
| Document Title | Year | Source |
|---|---|---|
| Viberzi (eluxadoline) Prescribing Information. | 2020 | Allergan USA, Inc., Madison, NJ |
Systematic Reviews / Meta-Analyses
| Document Title | Year | Source |
|---|---|---|
| Eluxadoline Versus Antispasmodics in the Treatment of Irritable Bowel Syndrome: An Adjusted Indirect Treatment Comparison Meta-analysis | 2022 | Frontiers in pharmacology |
| Efficacy of opioid receptor modulators in patients with irritable bowel syndrome: a systematic review and meta-analysis. | 2021 | Medicine |
| Adverse events in trials of licensed drugs for irritable bowel syndrome with constipation or diarrhea: Systematic review and meta-analysis. | 2021 | Neurogastroenterology & Motility |
| Efficacy of pharmacological therapies in patients with IBS with diarrhoea or mixed stool pattern: systematic review and network meta-analysis. | 2020 | Gut |
| Australian public assessment report for eluxadoline. | 2018 | Australian Government: Department of Health |
| Clinical review report: eluxadoline (Viberzi). | 2018 | CADTH |
Clinical Practice Guidelines
| Document Title | Year | Source |
|---|---|---|
| AGA Clinical Practice Guideline on the Pharmacological Management of Irritable Bowel Syndrome With Diarrhea. | 2022 | Gastroenterology |
| Evidence-based clinical practice guidelines for irritable bowel syndrome 2020. | 2021 | Journal of Gastroenterology |
| Canadian Association of Gastroenterology clinical practice guideline for the management of irritable bowel syndrome (IBS). | 2020 | Journal of the Canadian Association of Gastroenterology |