Ebastine may provide subjective relief among patients with non-constipated IBS

They evaluated the histamine 1 receptor antagonist ebastine as a potential treatment for patients with non-constipated irritable bowel syndrome (IBS) in a randomised, placebo-controlled phase 2 study. Non-constipated patients with IBS fulfilling the Rome III criteria were randomly assigned to 20 mg ebastine or placebo for 12 weeks. Subjects scored global relief of symptoms (GRS) and abdominal pain intensity (API). A subject was considered a weekly responder for global relief of symptoms if total or obvious relief was reported and a responder for abdominal pain intensity if the weekly average pain score was reduced by at least 30% vs baseline. The primary endpoints were the proportion of subjects who were weekly responders for at least 6 out of the 12 treatment weeks for both global relief of symptoms and abdominal pain intensity 'GRS+API', composite endpoint) and for global relief of symptoms and abdominal pain intensity separately. Results: 202 participants (32±11 years, 68% female) were randomly allocated to receive ebastine (n=101) or placebo (n=101). Treatment with ebastine resulted in significantly more responders (12%, 12/92) for global relief of symptoms+abdominal pain intensity compared with placebo (4%, 4/87, p=0.047) while the proportion of responders for global relief of symptoms and abdominal pain intensity separately was higher for ebastine compared with placebo, although not statistically significant (placebo vs ebastine, global relief of symptoms: 7% (6/87) vs 15%. The study shows that ebastine is superior to placebo and should be further evaluated as a novel treatment for patients with non-constipated IBS.

Reference:

Decraecker L, De Looze D, Hirsch DP, De Schepper H, Arts J, Caenepeel P, Bredenoord AJ, Kolkman J, Bellens K, Van Beek K, Pia F, Peetermans W, Vanuytsel T, Denadai-Souza A, Belmans A, Boeckxstaens G. Treatment of non-constipated irritable bowel syndrome with the histamine 1 receptor antagonist ebastine: a randomised, double-blind, placebo-controlled trial. Gut. 2024 Jan 8:gutjnl-2023-331634. doi: 10.1136/gutjnl-2023-331634. Epub ahead of print. PMID: 38191268.

Keywords:

Decraecker L, De Looze D, Hirsch DP, De Schepper H, Arts J, Caenepeel P, Bredenoord AJ, Kolkman J, Bellens K, Van Beek K, Pia F, Peetermans W, Vanuytsel T, Denadai-Souza A, Belmans A, Boeckxstaens G, Gut, Ebastine, treatment for IBS, non-constipated IBS, Gut, abdominal pain; irritable bowel syndrome; neural-immune interactions; visceral hypersensitivity