Guanylate cyclase-C agonists similarly effective in IBS-C, idiopathic constipation

Last Updated: 2018-02-19

By Reuters Staff

NEW YORK (Reuters Health) - The guanylate cyclase-C agonists linaclotide and plecanatide provide similar efficacy and tolerability in treating irritable bowel syndrome with constipation (IBS-C) and chronic idiopathic constipation (CIC), according to a systematic review and meta-analysis.

Both linaclotide and plecanatide are approved for the treatment of IBS-C and CIC, and some studies have suggested that diarrhea, a common side effect of this drug class, is less common with plecanatide.

Dr. Philip Schoenfeld and colleagues from the University of Michigan, in Ann Arbor, used data from eight linaclotide trials and seven plecanatide trials, including a total of more than 10,000 patients, to assess their relative efficacy and tolerability.

In meta-regression analyses, there were no significant differences between linaclotide and plecanatide in efficacy outcomes for IBS-C or CIC, the researchers report in The American Journal of Gastroenterology, online January 30.

Both drugs were more likely than placebo to be associated with diarrhea as an adverse event in IBS-C and CIC trials, but the rates did not differ between linaclotide and plecanatide in meta-regression analyses.

Similarly, linaclotide and plecanatide were more likely than placebo to be associated with study withdrawal due to diarrhea in IBS-C and CIC trials, but the rates did not differ between the drugs.

"The systematic presentation of study design and secondary endpoint results in this review may facilitate future research about the efficacy, tolerability, and safety of this drug class," the researchers conclude.

Dr. Schoenfeld has served as a consultant and advisory board member for Ironwood Pharmaceuticals, which makes linaclotide, and Synergy Pharmaceuticals, which makes plecanatide. The analysis did not have industry funding.

SOURCE: http://bit.ly/2sy11Hd

Am J Gastroenterol 2018.