Plecanatide 3 mg once daily effective for managing severe constipation in adults with CIC or IBS-C
An article published in Neurogastroenterology and Motility entitled "Plecanatide for the treatment of chronic idiopathic constipation and irritable bowel syndrome with constipation: Post hoc analyses of placebo-controlled trials in adults with severe constipation" by Dr Brooks D. Cash et al. and colleagues have concluded that plecanatide remains an option for managing patients with chronic idiopathic constipation or CIC and irritable bowel syndrome with constipation or IBS-C, including those with severe baseline symptoms.
This study found that 3- and 6-mg doses of plecanatide are superior to placebo for patients with severe CIC and IBS-C.
Patients with CIC and IBS-C experience severe symptoms. In this study, the team aimed to evaluate plecanatide in adults with CIC or IBS-C with symptoms of severe constipation.
Data were analyzed post hoc from trials CIC, IBS-C of plecanatide 3 mg, 6 mg, or placebo for 12 weeks. They measured primary efficacy endpoints as durable overall CSBM responders (CIC: ≥3 CSBMs/week, plus increase from baseline of ≥1 CSBM/week, for ≥9 of 12 weeks, including ≥3 of the last four weeks) and overall responders (IBS-C: ≥30% reduction from baseline in abdominal pain and ≥1 CSBM/week increase for ≥6 of 12 weeks.
The research summary could be explained as follows:
- They observed Severe constipation in 24.5% and 24.2% of CIC and IBS-C populations, respectively.
- The CIC durable overall CSBM response rate for plecanatide 3 mg, 6mg and placebo was 20.9%, 20.2% and 11.3%, respectively.
- IBS-C overall response rate for plecanatide 3 mg, 6 mg and placebo was 33.0%, 31.0% and 19.0%, respectively. This was significantly greater with plecanatide in comparison to placebo.
- Median time to first CSBM in CIC and IBS-C populations was shorter with plecanatide 3 mg compared to placebo.
They said Plecanatide effectively manages severe constipation in adults with CIC or IBS-C.
They explained that Constipation severity in CIC and IBS- C strongly correlates with reduced bowel movement frequency and more straining to achieve bowel movements.
The study's strengths are the large population size and rigorous definition of severe constipation.
Study limitations include the post hoc nature of the analysis, limited demographic representation, and lack of generalizability.
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