S1032 Safety and Efficacy of Eluxadoline for Irritable Bowel Syndrome (Diarrhea Predominant): Systematic Review and Meta-Analysis

Introduction: Irritable bowel syndrome with diarrhea (IBS-D) is a chronic functional disorder marked by frequent loose stools, urgency, and abdominal discomfort, significantly impairing quality of life. Eluxadoline, a mixed μ- and κ-opioid receptor agonist and δ-opioid antagonist, has emerged as a targeted treatment for IBS-D. This meta-analysis evaluates the efficacy and safety of eluxadoline in reducing diarrheal symptoms and improving overall symptom control in IBS-D patients. Methods: The review conducted follows the PRISMA guidelines and major medical databases, which include PUBMED, Google Scholar and Science-Direct, were extensively searched using a comprehensive search term to identify and retrieve available articles. The articles included the assessment of outcomes following eluxadoline therapy for IBS. The data was analyzed using the Meta, Metadata, and Metafor packages of R Studio. The efficacy of eluxadoline therapy was assessed by estimating the odds ratio (OR) of the primary end point efficacy between the 2 groups. The quality of life was assessed through the mean change in IBS-Quality of Life score (IBS-QOL). The Mantel-Haenszel method and the Inverse variance method were utilized to analyze the odds ratio and risk ratio. The I2 test was used to assess the heterogeneity of the studies. Results: The review includes a total of 7 articles that assessed the efficacy of eluxadoline for IBS compared with the placebo group. There are 2,929 in the intervention group (eluxadoline) and 2,934 in the placebo group. The primary outcome assessed was the odds ratio of efficacy of the drug eluxadoline vs placebo for the treatment of IBS. The odds of efficacy of the drug was significantly higher than the placebo group. (OR 1.68 [1.40; 2.02]; 95% CI; P = 0.0619; I2 = 50.0%.) The mean change in quality of life was assessed through improvement in IBS-QOL. (MDS = 1.97 [-0.18; 4.13]; 95% CI; P = 0.095; I2 = 52.9%.). Conclusion: The study conducted highlights the efficacy of eluxadoline therapy in the management of IBS-D. Improved outcomes of the primary end-point efficacy and improvement of IBS-QOL score warrant the use of eluxadoline as a therapeutic option in management of IBS-D.