Tags

Type your tag names separated by a space and hit enter

Linaclotide: a novel agent for chronic constipation and irritable bowel syndrome.
Am J Health Syst Pharm 2014; 71(13):1081-91AJ

Abstract

PURPOSE

The pharmacology, pharmaco-kinetics, and clinical efficacy and safety of linaclotide in the management of chronic constipation (CC) and constipation-predominant irritable bowel syndrome (IBS-C) are reviewed.

SUMMARY

Linaclotide (Linzess, Forest Pharmaceuticals) is a 14-amino acid peptide indicated for the treatment of adults with CC and IBS-C. Linaclotide acts on guanylate cyclase-C receptors on the luminal membrane to increase chloride and bicarbonate secretions into the intestine and inhibit the absorption of sodium ions, thus increasing the secretion of water into the lumen and improving defecation; the drug is minimally absorbed into the systemic circulation. Linaclotide is approved by the Food and Drug Administration (FDA) for oral once-daily administration at doses of 145 μg for CC and 290 μg for IBS-C. In placebo-controlled Phase III clinical trials, linaclotide significantly increased weekly spontaneous bowel movements and complete spontaneous bowel movements (CSBMs) while reducing abdominal pain in patients with CC. In patients with IBS-C, linaclotide was demonstrated to be effective in meeting FDA-recommended endpoints such as reductions of at least 30% from baseline in abdominal pain scores and CSBM frequency. The most common adverse effect of linaclotide is diarrhea, which was reported in 16-20% of clinical trial participants.

CONCLUSION

Linaclotide is an important advance in the treatment of CC and IBS-C, with a novel mechanism of action resulting in accelerated intestinal transit. In clinical trials, linaclotide demonstrated efficacy relative to placebo for treatment of both CC and IBS-C. Linaclotide's adverse effects are generally mild and confined to the gastrointestinal tract.

Authors+Show Affiliations

Bryan L. Love, Pharm.D., BCPS, is Associate Professor, Clinical Pharmacy and Outcomes Sciences, South Carolina College of Pharmacy, and Clinical Pharmacy Specialist-Gastroenterology/Hepatology, William Jennings Bryan Dorn Veterans Affairs Medical Center, Columbia, SC. Audrey Johnson is a Pharm.D. candidate, South Carolina College of Pharmacy. Lisa S. Smith, Pharm.D., BCPS, is Assistant Dean of Faculty Development and Associate Professor, Wingate University School of Pharmacy, Wingate, NC. loveb@sccp.sc.edu.Bryan L. Love, Pharm.D., BCPS, is Associate Professor, Clinical Pharmacy and Outcomes Sciences, South Carolina College of Pharmacy, and Clinical Pharmacy Specialist-Gastroenterology/Hepatology, William Jennings Bryan Dorn Veterans Affairs Medical Center, Columbia, SC. Audrey Johnson is a Pharm.D. candidate, South Carolina College of Pharmacy. Lisa S. Smith, Pharm.D., BCPS, is Assistant Dean of Faculty Development and Associate Professor, Wingate University School of Pharmacy, Wingate, NC.Bryan L. Love, Pharm.D., BCPS, is Associate Professor, Clinical Pharmacy and Outcomes Sciences, South Carolina College of Pharmacy, and Clinical Pharmacy Specialist-Gastroenterology/Hepatology, William Jennings Bryan Dorn Veterans Affairs Medical Center, Columbia, SC. Audrey Johnson is a Pharm.D. candidate, South Carolina College of Pharmacy. Lisa S. Smith, Pharm.D., BCPS, is Assistant Dean of Faculty Development and Associate Professor, Wingate University School of Pharmacy, Wingate, NC.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

24939497

Citation

Love, Bryan L., et al. "Linaclotide: a Novel Agent for Chronic Constipation and Irritable Bowel Syndrome." American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists, vol. 71, no. 13, 2014, pp. 1081-91.
Love BL, Johnson A, Smith LS. Linaclotide: a novel agent for chronic constipation and irritable bowel syndrome. Am J Health Syst Pharm. 2014;71(13):1081-91.
Love, B. L., Johnson, A., & Smith, L. S. (2014). Linaclotide: a novel agent for chronic constipation and irritable bowel syndrome. American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists, 71(13), pp. 1081-91. doi:10.2146/ajhp130575.
Love BL, Johnson A, Smith LS. Linaclotide: a Novel Agent for Chronic Constipation and Irritable Bowel Syndrome. Am J Health Syst Pharm. 2014 Jul 1;71(13):1081-91. PubMed PMID: 24939497.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Linaclotide: a novel agent for chronic constipation and irritable bowel syndrome. AU - Love,Bryan L, AU - Johnson,Audrey, AU - Smith,Lisa S, PY - 2014/6/19/entrez PY - 2014/6/19/pubmed PY - 2015/2/7/medline SP - 1081 EP - 91 JF - American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists JO - Am J Health Syst Pharm VL - 71 IS - 13 N2 - PURPOSE: The pharmacology, pharmaco-kinetics, and clinical efficacy and safety of linaclotide in the management of chronic constipation (CC) and constipation-predominant irritable bowel syndrome (IBS-C) are reviewed. SUMMARY: Linaclotide (Linzess, Forest Pharmaceuticals) is a 14-amino acid peptide indicated for the treatment of adults with CC and IBS-C. Linaclotide acts on guanylate cyclase-C receptors on the luminal membrane to increase chloride and bicarbonate secretions into the intestine and inhibit the absorption of sodium ions, thus increasing the secretion of water into the lumen and improving defecation; the drug is minimally absorbed into the systemic circulation. Linaclotide is approved by the Food and Drug Administration (FDA) for oral once-daily administration at doses of 145 μg for CC and 290 μg for IBS-C. In placebo-controlled Phase III clinical trials, linaclotide significantly increased weekly spontaneous bowel movements and complete spontaneous bowel movements (CSBMs) while reducing abdominal pain in patients with CC. In patients with IBS-C, linaclotide was demonstrated to be effective in meeting FDA-recommended endpoints such as reductions of at least 30% from baseline in abdominal pain scores and CSBM frequency. The most common adverse effect of linaclotide is diarrhea, which was reported in 16-20% of clinical trial participants. CONCLUSION: Linaclotide is an important advance in the treatment of CC and IBS-C, with a novel mechanism of action resulting in accelerated intestinal transit. In clinical trials, linaclotide demonstrated efficacy relative to placebo for treatment of both CC and IBS-C. Linaclotide's adverse effects are generally mild and confined to the gastrointestinal tract. SN - 1535-2900 UR - https://www.unboundmedicine.com/medline/citation/24939497/Linaclotide:_a_novel_agent_for_chronic_constipation_and_irritable_bowel_syndrome_ L2 - https://academic.oup.com/ajhp/article-lookup/doi/10.2146/ajhp130575 DB - PRIME DP - Unbound Medicine ER -