Efficacy of Eluxadoline for the Treatment of Irritable Bowel Syndrome with Diarrhea (IBS-D): A Systematic Review

Abstract

Introduction: Irritable Bowel Syndrome with Diarrhea (IBS-D) is a functional gastrointestinal disorder that significantly impairs quality of life. Eluxadoline is a mixed mu- and kappa-opioid receptor agonist and delta-opioid receptor antagonist developed to treat IBS-D symptoms.

Methods: We conducted a systematic search for placebo-controlled RCTs of eluxadoline in adult patients with IBS-D. The primary outcome was the composite response of simultaneous improvement in abdominal pain and stool consistency.

Results: The meta-analysis of three Phase 3 RCTs showed that eluxadoline was significantly more effective than placebo in achieving a composite response. It improved stool consistency, reduced abdominal pain, and decreased bowel urgency. Pancreatitis and sphincter of Oddi spasm were identified as rare but serious adverse events.

Discussion: Eluxadoline is an effective treatment for the core symptoms of IBS-D. However, its use is contraindicated in patients without a gallbladder due to an increased risk of pancreatitis, which limits its clinical application.

Conclusion: Eluxadoline is effective for the symptomatic treatment of IBS-D, but its use requires careful patient selection due to the risk of pancreatitis.