China
Africa
Explore chapters and articles related to this topic
The lower gastrointestinal tract, common conditions, and recommended treatments
Published in Simon R. Knowles, Laurie Keefer, Antonina A. Mikocka-Walus, Psychogastroenterology for Adults, 2019
In patients not responding to optimisation of laxatives, further investigations are generally performed to attempt to determine whether slow transit or pelvic floor dysfunction (see later) is the predominant pathology. Prokinetic agents, which stimulate the bowel to contract, such as pruclopride may be helpful in those with suspected motility dysfunction. Secretologues such as lubiprostone, linaclotide, or plecanatide, which increase the secretion of fluid into the lumen, also improve bowel consistence and frequency. Linaclotide and plecanatide also have anti-nociceptive effects which can lead to decreased abdominal pain [28].
Long-term treatment with plecanatide was safe and tolerable in patients with irritable bowel syndrome with constipation
Published in Current Medical Research and Opinion, 2019
Charles F. Barish, Robert A. Crozier, Patrick H. Griffin
Plecanatide is the most recent treatment for IBS-C to receive approval in the US and is also indicated for treatment of adults with chronic idiopathic constipation (CIC). Plecanatide acts to improve both the altered bowel function and abdominal pain that typifies IBS10–14. An analog of human uroguanylin (an endogenous peptide found in the intestinal tract), plecanatide binds to luminal GC-C receptors in a pH-sensitive manner15,16. Plecanatide binding to the GC-C receptor stimulates the intracellular production of cGMP, resulting in luminal salt accumulation and movement of water into the intestinal lumen17, contributing to normal bowel movements. In recent pre-clinical studies, plecanatide attenuated visceral hypersensitivity in animal models of visceral pain18.
Safety and tolerability of plecanatide in patients with chronic idiopathic constipation: long-term evidence from an open-label study
Published in Current Medical Research and Opinion, 2018
Charles F. Barish, Patrick Griffin
Safety, tolerability, and compliance are key pillars in effectively managing CIC symptoms. This fixed-dose, open-label study of plecanatide (3 mg and 6 mg) in adults with CIC provides evidence that plecanatide is safe and well tolerated during chronic treatment, with the vast majority (97%) being considered compliant with study medication. Plecanatide is the first uroguanylin analog to be evaluated in clinical trials of functional gastrointestinal disorders and to be approved in the US for the treatment of adults with CIC. Short-term (12-week) findings15,16 that once-daily plecanatide was safe and associated with low rates of TEAEs are confirmed in this long-term, open-label study. The incidences of diarrhea in the two 12-week CIC studies were 5.9% and 3.2% for plecanatide 3 mg and 5.7% and 4.5% for plecanatide 6 mg15,16, compared to the overall diarrhea incidence of 7.1% found in this study. In addition, similar rates of discontinuations due to diarrhea were reported in the 12-week studies, as were observed in this trial. Based on the results from the short-term studies and this long-term study, the safety and tolerability profile of plecanatide does not change with chronic use.
Plecanatide for the treatment of chronic idiopathic constipation in adult patients
Published in Expert Review of Clinical Pharmacology, 2019
Gabrio Bassotti, Paolo Usai Satta, Massimo Bellini
From the evidence of the available literature, it can be stated that plecanatide is an effective and safe drug for patients with CIC. As it is a uroguanylin analog, plecanatide is able to activate GC-C in a pH-dependent manner [34], with an optimal targeting that enables it to stimulate intraluminal intestinal fluid secretion and, like linaclotide [25], to decrease fecal consistency and normalize bowel movements. Notably, the drug seems devoid of important AE, apart from diarrhea. However, this side effect is complained of in less than 10% of treated patients and causes interruption of the treatment in less than 6% of patients [26]. This is an important point, and we can foresee that plecanatide might have a prominent role as a therapeutic agent to treat CIC.