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Wiley InterScience

The American Journal of Gastroenterology

The American Journal of Gastroenterology

Volume 102 Issue 7, Pages 1436 - 1441

Published Online: 31 Mar 2007

© 2008 American College of Gastroenterology/Blackwell Publishing



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A Randomized, Multicenter, Placebo-Controlled Trial of Polyethylene Glycol Laxative for Chronic Treatment of Chronic Constipation
Jack A. DiPalma, M.D., F.A.C.G. 1 , Mark vB. Cleveland, Ph.D. 1 , John McGowan, B.S. 1 , and Jorge L. Herrera, M.D., F.A.C.G. 1
  1 Division of Gastroenterology, University of South Alabama College of Medicine, Mobile, Alabama and Braintree Laboratories, Inc., Braintree, Massachusetts
  Reprint requests and correspondence: Jack A. DiPalma, M.D., Gastroenterology Academic Offices, USA Pavilion at Infirmary West, 5600 Girby Road, Mobile, AL 36693.
Copyright 2007 by Am. Coll. of Gastroenterology

(Am J Gastroenterol 2007;102:1436–1441)

ABSTRACT

OBJECTIVES:  Polyethylene glycol (PEG) 3350 (MiraLAX) is currently approved for the short-term treatment of occasional constipation. This study was designed to compare the safety and efficacy of PEG laxative versus placebo over a 6-month treatment period in patients with chronic constipation.

METHODS:  Study subjects who met defined criteria for chronic constipation were randomized in this double-blind, placebo-controlled, parallel, multicenter study to receive PEG laxative as a single daily dose of 17 g or placebo for 6 months. Baseline constipation status was confirmed during a 14-day observation period. As a primary efficacy variable, treatment success was defined as relief of modified ROME criteria for constipation for 50% or more of their treatment weeks. Various secondary measures were assessed. An Interactive Voice Response System (IVRS) recorded daily bowel movement experience and study efficacy and safety information. Laboratory testing at baseline and monthly for the study duration was analyzed for hematology, blood chemistry including amylase, GGT, uric acid, lipids, and urinalysis.

RESULTS:  A total of 304 patients were enrolled and received treatment at one of 50 centers. Successful treatment according to the primary efficacy variable was seen in 52.0% of PEG and 11% of placebo subjects (P < 0.001). Similar efficacy was seen in a subgroup of 75 elderly subjects. According to the primary efficacy definition (based on individual treatment weeks), 61% of PEG treatment weeks versus 22% of the placebo weeks were successful (P < 0.001). There were no significant differences in laboratory findings or adverse events except for the gastrointestinal category where diarrhea, flatulence, and nausea were the most frequent with PEG although they were not individually statistically significant compared with placebo. Similar results were observed when analyzed for differences due to gender, race, or age.

CONCLUSIONS:  PEG laxative is safe and effective for use in patients with chronic constipation for 6 months.


Received September 22, 2006; accepted February 7, 2007.

DIGITAL OBJECT IDENTIFIER (DOI)
10.1111/j.1572-0241.2007.01199.x About DOI

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