GuidelineAGA Clinical Practice Guideline on the Pharmacological Management of Irritable Bowel Syndrome With Constipation
Section snippets
Objective
Since the AGA published the first IBS technical review (TR) and guideline in 2014,16,17 new pharmacological treatments have become available and new evidence has accumulated about established treatments. The purpose of these guidelines is to provide updated evidence-based recommendations for the pharmacological management of individuals with IBS-C based on a systematic and comprehensive synthesis of the literature. In addition, we included recommendations for the following 3 classes of
Overview
This document represents the official recommendations of the AGA and was developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. and adheres to best practices in guideline development, as outlined by the National Academy of Medicine (formerly Institute of Medicine) previously. Development of this guideline was fully funded by the AGA Institute.18
Guideline Panel Composition and Conflict of Interest
Members of the guideline and TR panels were selected on the basis of their clinical and methodological
Recommendations
A summary of all the recommendations is provided in Table 1. A description of included studies is provided in Table 4 and an overview of the relative and absolute effect estimates for the critical outcomes is provided in Table 5. For all recommendations in this document, the pharmacological agent was compared with “no drug treatment.”
Acknowledgments
The authors sincerely thank Kellee Kaulback, Medical Information Officer, for helping in the literature search for the evidence review.
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Correspondence Address correspondence to: Chair, Clinical Guidelines Committee, American Gastroenterological Association, National Office, 4930 Del Ray Avenue, Bethesda, Maryland 20814. e-mail: [email protected].
Conflicts of interest These authors disclose the following: Lin Chang has served as a member of the scientific advisory boards for Ardelyx, Immunic, Ironwood Mauna Kea Technologies, and Protagonist. She has served as a consultant for Trellus and a speaker for Abbvie. She has received research support from the National Institute of Health, Arena, AnX Robotica, and Ironwood. She has stock options with ModifyHealth and Trellus. Anthony Lembo has served as a member of the scientific advisory board for Arena, Ardelyx, Bioamerica, IM HealthSciences, Mauno Kea Technologies, Ironwood, Mylan, Orpho-Med, Ritter, Shire, Takeda, Vibrant and Allergan. He has received research support for clinical trials from National Institute of Health, Arena, Takeda, Vanda, and Vibrant, and Vanda. The remaining authors disclose no conflicts.
Funding G. Nicholas Verne is supported by the National Institute of Diabetes and Digestive and Kidney Diseases (DK099052 and DK118959). Shahnaz Sultan is supported by the National Heart, Lung, and Blood Institute at the National Institute of Health for Asthma Guideline Development.
This article has an accompanying continuing medical education activity, also eligible for MOC credit, on page e15. Learning Objective: Upon completion of this CME activity, successful learners will be able to identify pharmacologic treatment options for the management of individuals with IBS-C.
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Authors share co-first authorship.