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Old 09-28-2006, 09:26 PM #1
wannabe wannabe is offline
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Default tegaserod (Zelnorm) in patients with MS

From the Ectrims site:

http://www.akm.ch/ectrims2006/

An open-label trial of tegaserod in patients with multiple sclerosis and bowel dysfunction

D. Woo, A. Salter, G. Remington, B. Fort, P. Creasy, E.M. Frohman (Milwaukee, Dallas, USA)

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Objective: To evaluate the use of tegaserod in multiple sclerosis (MS) patients with bowel constipation.

Background: Constipation affects an estimated 36% to 54% of the MS patient population, versus only 5% of the general population. Increasing severity of constipation has been correlated with increasing age, increased age at onset of MS, disease duration, severity of neurologic decline, and the comorbid presence of genitourinary symptoms. Significant constipation can occur despite a mild disease course, and may lead to abdominal discomfort, pain, loss of appetite and weight reduction, and magnification of other MS-related symptom complexes such as spasticity and bladder urgency.

Method: We retrospectively identified 36 patients from our clinic who were started on tegaserod at intervals ranging from 1 to 22 months prior to inception of this study, and asked them to respond anonymously to a questionnaire administered by postal service.

Patients were requested to quantify the effect of tegaserod on the weekly frequency of their bowel movements, the consistency of their stool, and the pain of their bowel habits. In addition, patients were asked to comment on the benefit of tegaserod on their overall well-being as measured by the Subject’s Global Assessment of Relief, and to report the occurrence of any adverse effects as well as details about their adherence with the medication. We also inquired about which therapeutic agents the patients had used prior to starting on tegaserod.

Results: Twenty out of 36 patients returned the questionnaire. We performed a primarily descriptive data analysis because of our small sample size and retrospective, unblinded trial design. Spearman rank order correlation showed correlations between the SGA of Relief and associations with tegaserod on improvements in pain (r = -0.680, p< 0.001), consistency (r = -0.654, p< 0.002) and frequency (r = 0.822, p<0.0001). Tegaserod was well-tolerated by the majority of patients, with the most frequent reported side effects being abdominal discomfort or pain (10%), excessive gas (5%), and hair loss (5%).

Conclusion: Tegaserod was generally tolerated by patients with a sizeable number of them experiencing improvement in bowel evacuation habits, which appeared to correlate with more global improvements in perceived, overall well-being. Currently, we are beginning a prospective, randomized, double-blinded, placebo-controlled, crossover trial of tegaserod in MS patients with bowel dysmotility.
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Old 09-30-2006, 07:12 AM #2
dayle dayle is offline
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This drug has been a lifesaver for my ms related dymotility problems. Not prefect by any means, but has probably spared me a colostomy.
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Old 10-02-2006, 06:56 PM #3
wannabe wannabe is offline
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Thanks for the input dayle. I have been thinking of trying it but wanted to give diet one last try first. But it's still not working so think I will go the Zenorm route and see if it helps.
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Old 10-02-2006, 07:49 PM #4
dayle dayle is offline
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Don't be surprised if zelnorm gives you the runs the first few days..it did to me, but painless not like a laxative. After a few days it stopped. Every once in a while i find i need to stop for a few days and go through that cycle again..

And the cool thing is not one UTI since starting(and i was getting them monthly), because there is no mass pressing on my bladder all the time. Don't even need poise pads all the time.
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Old 10-02-2006, 07:57 PM #5
wannabe wannabe is offline
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You answered my question before I even remembered that I wanted to ask it!

I was going to ask you about going off it now and then, because it says it isn't for ongoing use but only for temporary use. So I was going to ask you whether you stay on it, or give yourself breaks.

And you answered it!

Thanks. I'll give it a try and hope that it helps. I just can't stand the distended feeling I constantly have, among other problems not suitable for discussion during afternoon tea with the ladies.
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