New pharmacological treatment options for chronic constipation

Abstract

Introduction: A number of new medications were recently demonstrated to be more effective than placebo in treating chronic constipation, including the intestinal chloride channel activator lubiprostone, the prokinetic selective 5-HT4 receptor agonist prucalopride and the guanylate cyclase-C agonist linaclotide. Recent publications have also revisited traditional laxatives like PEG. Moreover, a number of pharmacological treatments are in development and these include another guanylate cyclase-C agonist, plecanatide and an ileal bile acid transporter inhibitor, elobixibat.

Areas covered: This review focuses on the pharmacology, efficacy and safety profile of prucalopride, linaclotide, plecanatide and elobixibat.

Expert opinion: The possible present or future clinical application of prucalopride, linaclotide, plecanatide and elobixibat in both chronic constipation and irritable bowel syndrome with constipation is reported, and some considerations on the possible role of PEG taking into account recent literature are advanced.

Keywords::

• 5-HT4
• chronic constipation
• irritable bowel syndrome with constipation
• guanylate cyclase-C
• ileal bile acid transporter inhibitor
• PEG

Declaration of interests

J Tack has received research grants or support from Abbott and Shire; he has been part of speakers bureau’s for Abbott, Almirall, AstraZeneca, Danone, Janssen, Menarini, Novartis, Shire, Takeda and Zeria; and has scientifically advised Almirall, AstraZeneca, Cosucra, Danone, Ferring, GI Dynamics, GlaxoSmithKline, Ironwood, Janssen, Menarini, Novartis, Rhythm, Shire, Takeda, Theravance, Tranzyme, Tsumura, Will pharma and Zeria. M Corsetti has no competing interests to disclose.

Notes

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