Eluxadoline: A Review in Diarrhoea-Predominant Irritable Bowel Syndrome.
Eluxadoline (Truberzi) is an orally administered, minimally absorbed agent that acts locally in the gastrointestinal tract as a mixed µ-opioid receptor agonist and δ-opioid receptor antagonist.
The randomized, double-blind, placebo-controlled, multinational, phase 3 IBS-3001 and IBS-3002 trials examined the efficacy of eluxadoline in patients with diarrhoea-predominant irritable bowel syndrome (IBS-D). The composite response rate (i.e. the proportion of patients with improvement in both worst abdominal pain and stool consistency on ≥50% of days; primary endpoint), was significantly higher in patients receiving eluxadoline 100 mg twice daily than in those receiving placebo after 12 and 26 weeks' therapy. Other abdominal and bowel symptoms (e.g. bloating, urgency, frequency of bowel movement) and health-related quality of life scores were also improved with eluxadoline. Eluxadoline was generally well tolerated in patients with IBS-D. Constipation was the most commonly occurring adverse event, although no serious constipation events were reported. Pancreatitis and adverse events consistent with sphincter of Oddi spasm were uncommon. In conclusion, eluxadoline is a new option to consider in the treatment of adult patients with IBS-D.