medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2017-15-51-55medsovet-2064Research ArticleЗАБОЛЕВАНИЯ КИШЕЧНИКАBOWEL DISEASESПРУКАЛОПРИД В ЛЕЧЕНИИ ХРОНИЧЕСКИХ ЗАПОРОВPRUKALOPRIDE IN THE TREATMENT OF CHRONIC CONSTIPATIONПлотниковаЕ. Ю.PlotnikovaE. Y.

д.м.н., профессор

MD, Prof.

ГрачеваТ. Ю.GrachevaT. U.

д.м.н., профессор

MD, Prof.

Кемеровский государственный медицинский университет Минздрава РоссииРоссияKemerovo State Medical University of the Ministry of Health of RussiaRussian Federation2017041120170155155Copyright © Плотникова Е.Ю., Грачева Т.Ю., 20172017Плотникова Е.Ю., Грачева Т.Ю.Plotnikova E.Y., Gracheva T.U.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/2064

В статье представлены факторы, которые участвуют в развитии запора. Основное значение имеет нарушение моторной функции кишечника, характеризующееся неэффективным продвижением содержимого по толстой кишке. Фармакологическое воздействие на 5НТ4-серотониновые рецепторы пациентов с запорами является наиболее физиологическим путем восстановления моторики толстой кишки, сохраняющим суточные ритмы дефекации, инициирующим ее высокоамплитудные пропульсивные сокращения без существенных побочных эффектов, свойственных некоторым энтерокинетикам и слабительным препаратам. Методом такого воздействия является применение прукалоприда. Он эффективен при хроническом запоре и обеспечивает новые терапевтические альтернативы пациентам, у которых симптомы запора не были полностью устранены слабительными средствами. Представлен отечественный прукалоприд Вегапрат.

 

The article provides factors that are involved in development of constipation. The main concern is the impairment of the motor function of the intestine, which is characterized by the ineffective movement of the contents of the colon. The pharmacological effect on 5NT4 -serotonin receptors of patients is the most physiological way to restore the motor functions of the intestine, which preserves the daily rhythms of the defecation, initiate its high-amplitude propulsion reductions without significant side effects characteristic of some enterokinetic agents and laxatives. The use of prukalopride is a method of such action. It is effective in the case of chronic constipation and provides new therapeutic alternatives to patients whose symptoms have not been completely eliminated by laxatives. A new Russian prukalopride Vegaprat was launched.

 

запор5НТ4-серотониновые рецепторыслабительные средствапрукалопридconstipation5NT4-serotonin receptorslaxativesprukaloprideReferencesРимские IV рекомендации по диагностике и лечению функциональных гастроэнтерологических расстройств: пособие для врачей / С.И. Пиманов, Н.И. Сливочник. М.: 2016. 160 с.: ил.Римские IV рекомендации по диагностике и лечению функциональных гастроэнтерологических расстройств: пособие для врачей / С.И. Пиманов, Н.И. Сливочник. М.: 2016. 160 с.: ил.Drossman DA. Functional Gastrointestinal Disorders: History, Pathophysiology, Clinical Features and Rome IV. Gastroenterology. 2016; Feb 19, pii: S0016-5085(16)00223-7.Drossman DA. Functional Gastrointestinal Disorders: History, Pathophysiology, Clinical Features and Rome IV. Gastroenterology. 2016; Feb 19, pii: S0016-5085(16)00223-7.Sonnenberg A, Koch TR. Epidemiology of constipation in the United States. Dis Colon Rectum. 1989; 32: 1–8.Sonnenberg A, Koch TR. Epidemiology of constipation in the United States. Dis Colon Rectum. 1989; 32: 1–8.Locke GR, 3rd, Pemberton JH, Phillips SF. AGA technical review on constipation. American Gastroenterological Association. Gastroenterology. 2000; 119: 1766–1778.Locke GR, 3rd, Pemberton JH, Phillips SF. AGA technical review on constipation. American Gastroenterological Association. Gastroenterology. 2000; 119: 1766–1778.Müller-Lissner SA. Effect of wheat bran on weight of stool and gastrointestinal transit time: a meta analysis. Br Med J (Clin Res Ed) 1988; 296: 615–617.Müller-Lissner SA. Effect of wheat bran on weight of stool and gastrointestinal transit time: a meta analysis. Br Med J (Clin Res Ed) 1988; 296: 615–617.Petticrew M, Rodgers M, Booth A. Effectiveness of laxatives in adults. Qual Health Care. 2001; 10: 268–273.Petticrew M, Rodgers M, Booth A. Effectiveness of laxatives in adults. Qual Health Care. 2001; 10: 268–273.Borum ML. Constipation: evaluation and management. Prim Care. 2001; 28: 577–590.Borum ML. Constipation: evaluation and management. Prim Care. 2001; 28: 577–590.Chaussade S, Minić M. Comparison of efficacy and safety of two doses of two different polyethylene glycol-based laxatives in the treatment of constipation. Aliment Pharmacol Ther. 2003;17:165–172.Chaussade S, Minić M. Comparison of efficacy and safety of two doses of two different polyethylene glycol-based laxatives in the treatment of constipation. Aliment Pharmacol Ther. 2003;17:165–172.Bouhnik Y, Neut C, Raskine L, et al. Prospective, randomized, parallel-group trial to evaluate the effects of lactulose and polyethylene glycol-4000 on colonic flora in chronic idiopathic constipation. Aliment Pharmacol Ther. 2004;19:889–899.Bouhnik Y, Neut C, Raskine L, et al. Prospective, randomized, parallel-group trial to evaluate the effects of lactulose and polyethylene glycol-4000 on colonic flora in chronic idiopathic constipation. Aliment Pharmacol Ther. 2004;19:889–899.Attar A, Lémann M, Ferguson A, et al. Comparison of a low dose polyethylene glycol electrolyte solution with lactulose for treatment of chronic constipation. Gut. 1999;44:226–230.Attar A, Lémann M, Ferguson A, et al. Comparison of a low dose polyethylene glycol electrolyte solution with lactulose for treatment of chronic constipation. Gut. 1999;44:226–230.Cleveland MV, Flavin DP, Ruben RA, Epstein RM, Clark GE. New polyethylene glycol laxative for treatment of constipation in adults: a rand-omized, double-blind, placebo-controlled study. South Med J. 2001; 94: 478–481.Cleveland MV, Flavin DP, Ruben RA, Epstein RM, Clark GE. New polyethylene glycol laxative for treatment of constipation in adults: a rand-omized, double-blind, placebo-controlled study. South Med J. 2001; 94: 478–481.Corazziari E, Badiali D, Bazzocchi G, et al. Long term efficacy, safety, and tolerability of low daily doses of isosmotic polyethylene glycol electrolyte balanced solution (PMF-100) in the treatment of functional chronic constipation. Gut. 2000; 46: 522–526.Corazziari E, Badiali D, Bazzocchi G, et al. Long term efficacy, safety, and tolerability of low daily doses of isosmotic polyethylene glycol electrolyte balanced solution (PMF-100) in the treatment of functional chronic constipation. Gut. 2000; 46: 522–526.MiraLax polyethylene glycol 3550, NF powder for solution. Braintree Laboratories, Inc; [accessed 21 April 2016]. Available from URL: http://www.drugs.com/cdi/polyethylene-glycol-3350-powder-for-oral-solution.html.MiraLax polyethylene glycol 3550, NF powder for solution. Braintree Laboratories, Inc; [accessed 21 April 2016]. Available from URL: http://www.drugs.com/cdi/polyethylene-glycol-3350-powder-for-oral-solution.html.Ramkumar D, Rao SSC. Efficacy and safety of traditional medical therapies for chronic constipation: systematic review. Am J Gastroenterol. 2005; 100: 936–971.Ramkumar D, Rao SSC. Efficacy and safety of traditional medical therapies for chronic constipation: systematic review. Am J Gastroenterol. 2005; 100: 936–971.Muller-Lissner SA, Kamm MA, Scarpignato C, Wald A. Myths and misconceptions about chronic constipation. Am J Gastroenterol. 2005; 100: 232–242.Muller-Lissner SA, Kamm MA, Scarpignato C, Wald A. Myths and misconceptions about chronic constipation. Am J Gastroenterol. 2005; 100: 232–242.Shafik A, Shafik AA, el-Sibai O, Ahmed I. Colonic pacing in patients with constipation due to colonic inertia. Med Sci Monit. 2003;9:CR243–CR248.Shafik A, Shafik AA, el-Sibai O, Ahmed I. Colonic pacing in patients with constipation due to colonic inertia. Med Sci Monit. 2003;9:CR243–CR248.Kenefick NJ, Vaizey CJ, Cohen CRG, Nicholls RJ, Kamm MA. Double-blind placebo-controlled crossover study of sacral nerve stimulation for idiopathic constipation. Br J Surg. 2002;89:1570–1571.Kenefick NJ, Vaizey CJ, Cohen CRG, Nicholls RJ, Kamm MA. Double-blind placebo-controlled crossover study of sacral nerve stimulation for idiopathic constipation. Br J Surg. 2002;89:1570–1571.Chang HS, Myung SJ, Yang SK, et al. Effect of electrical stimulation in constipated patients with impaired rectal sensation. Int J Colorectal Dis. 2003; 18: 433–438.Chang HS, Myung SJ, Yang SK, et al. Effect of electrical stimulation in constipated patients with impaired rectal sensation. Int J Colorectal Dis. 2003; 18: 433–438.Drossman DA, Toner BB, Whitehead WE, et al. Cognitive-behavioral therapy versus education and desipramine versus placebo for moderate to severe functional bowel disorders. Gastroenterology. 2003; 125: 19–31.Drossman DA, Toner BB, Whitehead WE, et al. Cognitive-behavioral therapy versus education and desipramine versus placebo for moderate to severe functional bowel disorders. Gastroenterology. 2003; 125: 19–31.Heymen S, Wexner SD, Vickers D, Nogueras JJ, Weiss EG, Pikarsky AJ. Prospective, randomized trial comparing four biofeedback techniques for patients with constipation. Dis Colon Rectum. 1999; 42: 1388–1393.Heymen S, Wexner SD, Vickers D, Nogueras JJ, Weiss EG, Pikarsky AJ. Prospective, randomized trial comparing four biofeedback techniques for patients with constipation. Dis Colon Rectum. 1999; 42: 1388–1393.Johanson JF, Wald A, Tougas G, et al. Effect of tegaserod in chronic constipation: a rand-omized, double-blind, controlled trial. Clin Gastroenterol Hepatol. 2004; 2: 796–805.Johanson JF, Wald A, Tougas G, et al. Effect of tegaserod in chronic constipation: a rand-omized, double-blind, controlled trial. Clin Gastroenterol Hepatol. 2004; 2: 796–805.Johanson JF. Review article: tegaserod for chronic constipation. Aliment Pharmacol Ther. 2004;20(suppl 7):20–24.Johanson JF. Review article: tegaserod for chronic constipation. Aliment Pharmacol Ther. 2004;20(suppl 7):20–24.Kamm MA, Müller-Lissner S, Talley NJ, et al. Tegaserod for the treatment of chronic constipation: a randomized, double-blind, placebo-controlled multinational study. Am J Gastroenterol. 2005; 100: 362–372.Kamm MA, Müller-Lissner S, Talley NJ, et al. Tegaserod for the treatment of chronic constipation: a randomized, double-blind, placebo-controlled multinational study. Am J Gastroenterol. 2005; 100: 362–372.Cash BD, Lacy BE. Systematic review: FDA-approved prescription medications for adults with constipation. Gastroenterol Hepatol. 2006; 2: 736–749.Cash BD, Lacy BE. Systematic review: FDA-approved prescription medications for adults with constipation. Gastroenterol Hepatol. 2006; 2: 736–749.Parkman HP, Rao SS, Reynolds JC, et al. Neurotrophin-3 improves functional constipation. Am J Gastroenterol. 2003; 98: 1338–1347.Parkman HP, Rao SS, Reynolds JC, et al. Neurotrophin-3 improves functional constipation. Am J Gastroenterol. 2003; 98: 1338–1347.Pepin C, Ladabaum U. The yield of lower endoscopy in patients with constipation: survey of a university hospital, a public county hospital, and a Veterans Administration medical center. Gastrointest Endosc 2002; 56: 325–332.Pepin C, Ladabaum U. The yield of lower endoscopy in patients with constipation: survey of a university hospital, a public county hospital, and a Veterans Administration medical center. Gastrointest Endosc 2002; 56: 325–332.Camilleri M, Bharucha AE, Ueno R, et al. Effect of a selective chloride channel activator, lubiprostone, on gastrointestinal transit, gastric sensory, and motor functions in healthy volunteers. Am J Physiol Gastrointestinal Liver Physiol. 2006;290:G942–G947.Camilleri M, Bharucha AE, Ueno R, et al. Effect of a selective chloride channel activator, lubiprostone, on gastrointestinal transit, gastric sensory, and motor functions in healthy volunteers. Am J Physiol Gastrointestinal Liver Physiol. 2006;290:G942–G947.Плотникова Е.Ю. Современные представления о запоре. Лечащий врач, 2015; 8: 7-18.Плотникова Е.Ю. Современные представления о запоре. Лечащий врач, 2015; 8: 7-18.Resolor, prucalopride. European Public Assessment Report (EPAR) Product Information. Updated 11/11/2011. Available at: http://www. ema.europa.eu/docs/en_GB/document_library/ EPAR_-_Product _Information/human/001012/ WC500053998.pdf.Resolor, prucalopride. European Public Assessment Report (EPAR) Product Information. Updated 11/11/2011. Available at: http://www. ema.europa.eu/docs/en_GB/document_library/ EPAR_-_Product _Information/human/001012/ WC500053998.pdf.Australian Public Assessment Report for Prucalopride. Therapeutic Goods Administration (TGA), Australian Government Department of Health and Ageing. November 2011. Available at:http://www.tga.gov.au/pdf/auspar/ausparresotrans.pdf.Australian Public Assessment Report for Prucalopride. Therapeutic Goods Administration (TGA), Australian Government Department of Health and Ageing. November 2011. Available at:http://www.tga.gov.au/pdf/auspar/ausparresotrans.pdf.Briejer MR, Bosmans JP, Van Daele P, et al. The in vitro pharmacological profile of prucalo-pride, a novel enterokinetic compound. Eur J Pharmacol. 2001;423:71–83.Briejer MR, Bosmans JP, Van Daele P, et al. The in vitro pharmacological profile of prucalo-pride, a novel enterokinetic compound. Eur J Pharmacol. 2001;423:71–83.Hegde SS, Eglen RM. Peripheral 5-HT4 receptors. Faseb J. 1996;10:1398–1407.Hegde SS, Eglen RM. Peripheral 5-HT4 receptors. Faseb J. 1996;10:1398–1407.Prins NH, Akkermans LM, Lefebvre RA, Schuurkes JA. 5-HT(4) receptors on cholinergic nerves involved in contractility of canine and human large intestine longitudinal muscle. Br J Pharmacol. 2000;131:927–932.Prins NH, Akkermans LM, Lefebvre RA, Schuurkes JA. 5-HT(4) receptors on cholinergic nerves involved in contractility of canine and human large intestine longitudinal muscle. Br J Pharmacol. 2000;131:927–932.Prins NH, Van Haselen JF, Lefebvre RA, Briejer MR, Akkermans LM, Schuurkes JA. Pharmacological characterization of 5-HT4 receptors mediating relaxation of canine isolated rectum circular smooth muscle. Br J Pharmacol. 1999; 127:1431–1437.Prins NH, Van Haselen JF, Lefebvre RA, Briejer MR, Akkermans LM, Schuurkes JA. Pharmacological characterization of 5-HT4 receptors mediating relaxation of canine isolated rectum circular smooth muscle. Br J Pharmacol. 1999; 127:1431–1437.Van de Velde V, Ausma J, Vandeplassche L. Pharmacokinetics of prucalopride (Resolor®) in man. Gut. 2008; 57: A282.Van de Velde V, Ausma J, Vandeplassche L. Pharmacokinetics of prucalopride (Resolor®) in man. Gut. 2008; 57: A282.Wong BS, Manabe N, Camilleri M. Role of prucalopride, a serotonin (5-HT(4)) receptor ago-nist, for the treatment of chronic constipation. Clin Exp Gastroenterol. 2010; 3: 49–56.Wong BS, Manabe N, Camilleri M. Role of prucalopride, a serotonin (5-HT(4)) receptor ago-nist, for the treatment of chronic constipation. Clin Exp Gastroenterol. 2010; 3: 49–56.Sajid MS, Hebbar M, Baig MK, Li A, Philipose Z. Use of Prucalopride for Chronic Constipation: A Systematic Review and Meta-analysis of Published Randomized, Controlled Trials. J Neurogastro enterol Motil. 2016 Jul 30; 22(3): 412–22.Sajid MS, Hebbar M, Baig MK, Li A, Philipose Z. Use of Prucalopride for Chronic Constipation: A Systematic Review and Meta-analysis of Published Randomized, Controlled Trials. J Neurogastro enterol Motil. 2016 Jul 30; 22(3): 412–22.Camilleri M, Beyens G, Kerstens R, Robinson P, Vandeplassche L. Safety assessment of prucalopride in elderly patients with constipation:Camilleri M, Beyens G, Kerstens R, Robinson P, Vandeplassche L. Safety assessment of prucalopride in elderly patients with constipation:a double-blind, placebo-controlled study. Neuro gastroenterol Motil. 2009; 21: 1256– e117.a double-blind, placebo-controlled study. Neuro gastroenterol Motil. 2009; 21: 1256– e117.Coremans G, Kerstens R, De Pauw M, Stevens M. Prucalopride is effective in patients with severe chronic constipation in whom laxatives fail to provide adequate relief. Results of a double-blind, placebo-controlled clinical trial. Digestion. 2003; 67: 82–89.Coremans G, Kerstens R, De Pauw M, Stevens M. Prucalopride is effective in patients with severe chronic constipation in whom laxatives fail to provide adequate relief. Results of a double-blind, placebo-controlled clinical trial. Digestion. 2003; 67: 82–89.Dubois D, Gilet H, Viala-Danten M, Tack J. Psychometric performance and clinical meaningfulness of the Patient Assessment of Consti pation-Quality of Life questionnaire in prucalopride (RESOLOR) trials for chronic constipation. Neurogastroenterol Motil 2010; 22: e54–63.Dubois D, Gilet H, Viala-Danten M, Tack J. Psychometric performance and clinical meaningfulness of the Patient Assessment of Consti pation-Quality of Life questionnaire in prucalopride (RESOLOR) trials for chronic constipation. Neurogastroenterol Motil 2010; 22: e54–63.Ke M, Zou D, Yuan Y, et al. Prucalopride in the treatment of chronic constipation in patients from the Asia-Pacific region: a randomized, double-blind, placebo-controlled study. Neurogastroenterol Motil. 2012;24(11):999–e541.Ke M, Zou D, Yuan Y, et al. Prucalopride in the treatment of chronic constipation in patients from the Asia-Pacific region: a randomized, double-blind, placebo-controlled study. Neurogastroenterol Motil. 2012;24(11):999–e541.Shin A. Patient considerations in the management of chronic constipation: focus on prucalo-pride. Patient Prefer Adherence. 2016; 10: 1373–1384.Shin A. Patient considerations in the management of chronic constipation: focus on prucalo-pride. Patient Prefer Adherence. 2016; 10: 1373–1384.Yiannakou Y, Piessevaux H, Bouchoucha M, et al. A randomized, double-blind, placebo-controlled, phase 3 trial to evaluate the efficacy, safety, and tolerability of prucalopride in men with chronic constipation. Am J Gastroenterol. 2015;110(5):741–7.Yiannakou Y, Piessevaux H, Bouchoucha M, et al. A randomized, double-blind, placebo-controlled, phase 3 trial to evaluate the efficacy, safety, and tolerability of prucalopride in men with chronic constipation. Am J Gastroenterol. 2015;110(5):741–7.URL: http://www.worldgastroenterology.org/ guidelines/global-guidelines/constipation.URL: http://www.worldgastroenterology.org/ guidelines/global-guidelines/constipation.Ивашкин В.Т., Абдулхаков С.Р., Баранская Е.К. и др. Клинические рекомендации Российской гастроэнтерологической ассоциации по диагностике и лечению взрослых пациентов с хроническим запором. РЖГГК. 2014; 5: 69–75.Ивашкин В.Т., Абдулхаков С.Р., Баранская Е.К. и др. Клинические рекомендации Российской гастроэнтерологической ассоциации по диагностике и лечению взрослых пациентов с хроническим запором. РЖГГК. 2014; 5: 69–75.Исследования биоэквивалентности по протоколу №PRU-BE-001 от 6 марта 2015 г.Исследования биоэквивалентности по протоколу №PRU-BE-001 от 6 марта 2015 г.

The authors declare that there are no conflicts of interest present.