'מערכת אימד'Lactulose plus paraffin may be used interchangeably with polyethylene glycol for the pharmacological treatment of functional constipation.
T Piche and M Dapoigny, United European Gastroenterology Journal
2020, Vol. 8(8) 923–932
https://onlinelibrary.wiley.com/doi/epdf/10.1177/2050640620937913
Abstract
Background: Few head-to-head comparisons of the different classes of laxatives have been conducted.
Objective: The objective of this work is to compare the efficacy of lactulose plus paraffin vs polyethylene glycol in the treatment of functional constipation (non-inferiority study).
Methods: This randomised, parallel-group, multicentre phase 4 study recruited patients with functional constipa-
tion diagnosed according to Rome III criteria. Patients received lactulose plus paraffin or polyethylene glycol for 28 days. The primary end point was the change from baseline in the Patient Assessment of Constipation–Symptoms (PAC-SYM) score.
Results: A total of 363 patients were randomised to lactulose plus paraffin (n ¼ 179) or polyethylene glycol
(n ¼ 184). On day 28, the mean PAC-SYM score decre ased significantly vs baseline with both treatments
(p < 0.001). The lower boundary of the 95% CI exceeded the pre-specified limit of 0.25, therefore establishing
non-inferiority of lactulose plus paraffin vs polyethylene glycol. At least one adverse event occurred in 20 patients
(11.2%) in the lactulose plus paraffin group and in 26 patients (14.2%) in the polyethylene glycol group, most of
which were of mild or moderate severity and unrelated to study drugs.
Conclusion: Lactulose plus paraffin may be used interchangeably with polyethylene glycol for the pharmacological treatment of functional constipation.
Trial registration: EudraCT number 2015-003021-34