Amitriptyline at Low-Dose and Titrated for Irritable Bowel Syndrome as Second-Line Treatment in primary care (ATLANTIS): a randomised, double-blind, placebo-controlled, phase 3 trial
- Ford, A.C.
- Wright-Hughes, A.
- Alderson, S.L.
- Ow, P.-L.
- Ridd, M.J.
- Foy, R.
- Bianco, G.
- Bishop, F.L.
- Chaddock, M.
- Cook, H.
- Cooper, D.
- Fernandez, C.
- Guthrie, E.A.
- Hartley, S.
- Herbert, A.
- Howdon, D.
- Muir, D.P.
- Nath, T.
- Newman, S.
- Smith, T.
- Taylor, C.A.
- Teasdale, E.J.
- Thornton, R.
- Farrin, A.J.
- Everitt, H.A.
- Ford, A.C.
- Wright-Hughes, A.
- Alderson, S.L.
- Ow, P.-L.
- Ridd, M.J.
- Foy, R.
- Barratt, M.
- Bianco, G.
- Bishop, F.L.
- Brindle, R.
- Brown, S.
- Chaddock, M.
- Christodoulou, A.
- Cook, H.
- Cooper, D.
- Day, F.
- Dowse, A.
- Durnell, J.
- Emmerson, J.
- Fellows, A.
- Fernandez, C.
- Guthrie, E.A.
- Hartley, S.
- Herbert, A.
- Hindmarch, D.
- Howdon, D.
- Malik, A.
- Morris, T.
- Muir, D.P.
- Longo, R.
- Lopes Goncalves Graca, S.
- Nath, T.
- Newman, S.
- Parker, C.
- Smith, T.
- Taylor, C.A.
- Teasdale, E.J.
- Thornton, R.
- Tubeuf, S.
- West, A.
- Williamson, E.-J.
- Farrin, A.J.
- Everitt, H.A.
DOIAbstract
Background Most patients with irritable bowel syndrome (IBS) are managed in primary care. When first-line therapies for IBS are ineffective, the UK National Institute for Health and Care Excellence guideline suggests considering low- dose tricyclic antidepressants as second-line treatment, but their effectiveness in primary care is unknown, and they are infrequently prescribed in this setting. Methods This randomised, double-blind, placebo-controlled trial (Amitriptyline at Low-Dose and Titrated for Irritable Bowel Syndrome as Second-Line Treatment [ATLANTIS]) was conducted at 55 general practices in England. Eligible participants were aged 18 years or older, with Rome IV IBS of any subtype, and ongoing symptoms (IBS Severity Scori...
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