Racecadotril is an antidiarrhoeal drug with a
pure intestinal antisecretory mechanism of action. Aim: To assess racecadotril efficacy,
whatever its dose, versus placebo in adult
acute diarrhoea. Methods: Individual Patient Data meta-analysis following multilevel
mixed models testing of the significance of the treatment effect adjusted for baseline
covariates. Diarrhoea duration was the common main criteria. Results: Four randomized
clinical trials (n = 669) were identified with raw data. The clinical global impression
evaluated at baseline by the physician was found to be the essential predictor influencing
the outcome. As compared to placebo, the 100 mg dose, the minimum effective dose,
induced a 80% increase of the recovered patient proportion at anytime (Hazard
Ratio = 1.8 [1.3, 2.5], p <
0.001), a 60% increase of the responder proportion i.e. recovery within 3 days (p < 0.001), a 47% reduction of abdominal pain and nausea and an overall 33% decrease
of sick days (p < 0.001).
In conclusion, as compared to placebo, racecadotril induced several significant
effects, such as reducing the diarrhoea duration, the number of stools and associated
symptoms, leading to less lost productivity.
Cite this paper
Coffin, B. , Hamza, H. , Vetel, J. and Lehert, P. (2014) Racecadotril in the Treatment of Acute Diarrhoea in Adults. An Individual Patient Data Based Meta-Analysis. International Journal of Clinical Medicine
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