New pharmacological treatment options for irritable bowel syndrome with constipation

Abstract

Introduction: Constipation predominant irritable bowel syndrome (IBS-C) is a common disorder and accounts for a large number of ambulatory visits. Sensory abnormalities, that is, presence of abdominal pain and discomfort, distinguish IBS-C from chronic idiopathic constipation.

Area covered: This review focuses on the pharmacology, efficacy, safety, and future of prucalopride, YKP-10811, DSP-6952, dexloxiglumide, linaclotide, plecanatide, tenapanor, and elobixibat.

Expert opinion: It is now well established that treatment focusing only on bowel transit provides incomplete relief to patients with IBS-C. Improved understanding of pathophysiology of IBS-C has led to use of sensory end points like complete spontaneous bowel movements and the FDA combined end point (abdominal pain and complete spontaneous bowel movements) in clinical trials. A number of drugs are in development and provide hope for this challenging group of patients. However, because of recent failures secondary to ineffectiveness and/or adverse events, we cautiously await how clinical data play out in larger studies and in clinical practice.

Keywords:

• bile acid transport inhibitor
• cholecystokinin receptor antagonist
• dexloxiglumide
• DSP-6952
• elobixibat
• guanylate cyclase-C agonist
• linaclotide
• plecanatide
• serotonin agonist
• sodium–proton exchange inhibitor
• tenapanor
• YKP-10811