Tegaserod for treating chronic constipation in elderly patients.

摘要

OBJECTIVE: To evaluate data that address the safety and efficacy of tegaserod for the management of chronic constipation (CC) in elderly patients. DATA SOURCES: Primary literature was identified through MEDLINE (1966-January 2007) and EMBASE (2002-January 2007) using the search terms tegaserod, elderly, and constipation. Additional information was requested from the pharmaceutical manufacturer. STUDY SELECTION AND DATA EXTRACTION: Clinical trials evaluating the efficacy and safety of tegaserod for treating CC were considered for inclusion. Emphasis was placed on data relevant to use of tegaserod in the elderly and on CC. DATA SYNTHESIS: Two efficacy trials evaluated tegaserod for treating constipation. They enrolled a total of 331 elderly patients, comprising approximately 13% of study patients. Tegaserod was effective for improving constipation in the overall study populations; no significant adverse events were noted. However, both studies lacked a subgroup analysis in the elderly. Diarrhea occurred more commonly with higher doses of tegaserod and may be a concern in older adults. A 13 month safety trial found tegaserod to be well tolerated for treatment of constipation, with similar adverse events seen as in the 12 week efficacy studies. Specific data were not provided for elderly patients. CONCLUSIONS: Tegaserod should not replace current therapies for treatment of CC in the elderly. The drug has been studied in a small number of older adults; thus, data are inconclusive about its use in this population. Older adults have a higher risk of diarrhea with tegaserod. Cautious use is warranted until further studies specifically address the elderly population.