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Pubmed-Efficacy of Drugs Acting on Histamine-1 Receptors in Irritable Bowel Syndrome: Systematic Review and Meta-analysis


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Gastroenterology. 2024 Mar 16:S0016-5085(24)00297-X. doi: 10.1053/j.gastro.2024.03.014. Online ahead of print.

There is increasing evidence that a subset of patients with irritable bowel syndrome (IBS) have an organic explanation for their symptoms. Some patients exhibit evidence of mast cell activation,1, 2 although the cause is unknown. Recent evidence suggests this could relate to a break in oral tolerance to a dietary antigen, following an acute enteric infection.3Degranulation of mast cells results in mucosal release of tryptase and histamine,1 and hence immune activation and visceral afferent neuron hyperexcitability. This has led to emerging interest in a potential role for histamine-1 receptor antagonists (H1RAs) as a treatment for IBS. A recent randomized controlled trial (RCT) of ebastine, a non-sedating H1RA, suggested a benefit of the drug in non-constipated IBS,4 but only for a composite endpoint of improvement in global symptoms and abdominal pain, not either endpoint separately. We, therefore, undertook a systematic review and meta-analysis to examine efficacy of drugs acting on histamine-1 receptors in IBS.

PMID:38499162 | DOI:10.1053/j.gastro.2024.03.014

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