Long-acting Mesalamine may effectively reduce symptoms in Postinfectious Irritable Bowel Syndrome: Study

Findings:

• Of the 61 participants, 54 completed the 8-week study with 28 in the mesalamine group and 26 in the placebo group.
• The majority of participants (91%) were male, with an age range of 23–71 years (mean ± SD: 43 ± 13 years).
• Mesalamine showed greater efficacy than placebo in reducing overall BSS, with a medium effect size (Cohen's d = 0.57, p = 0.042).
• A significant improvement in the secondary outcomes was noticed on how IBS affects daily life (d = 0.72, p = 0.01).
• For the individual IBS symptoms, all seven symptoms assessed showed trends favoring mesalamine, and eight of nine IBS-QOL subscales also showed trends indicating mesalamine's superiority.

In patients with PI-IBS, long-acting mesalamine was effective in reducing IBS symptoms and improving quality of life suggesting that mesalamine could be a promising treatment option for managing PI-IBS.

Take-home Points:

• This placebo-controlled randomized trial assessed the efficacy of 2.4 g of long-acting mesalamine for the treatment of postinfectious diarrhea-predominant IBS.
• Among 54 patients who underwent 8-week treatment, mesalamine resulted in greater improvements on the Bowel Symptoms Score (change, −13 vs −4; P = .042); however, the difference between mesalamine and placebo was no longer significant when the constipation subscore was removed.
• Apart from the Bowel Symptoms Score, mesalamine largely failed to demonstrate superiority to placebo for other measures of symptom severity and QoL measures.
• Mesalamine may have some role in improving overall symptom severity in postinfectious IBS; however, additional larger studies are needed.

Further reading: Tuteja, Ashok K et al. “Randomized double-blind placebo-controlled study to evaluate the effect of long-acting mesalamine on postinfectious irritable bowel syndrome with diarrhea.” Neurogastroenterology and motility, e14889. 5 Aug. 2024, doi:10.1111/nmo.14889