Two Randomized Trials of Linaclotide for Chronic Constipation

In two 12-week trials, linaclotide, a minimally absorbed peptide agonist of the guanylate cyclase-C receptor, increased the frequency of spontaneous bowel movements and improved symptoms in patients with chronic constipation. Longer-term studies are needed. Chronic constipation affects between 12 and 19% of the U.S. population. 1 , 2 The symptoms of chronic constipation, including infrequent bowel movements, hard stools, straining during defecation, bloating, abdominal discomfort, and a sense of incomplete evacuation, 3 adversely affect quality of life 4 , 5 and are associated with substantial costs. 6 , 7 Few currently available therapies for chronic constipation have been shown to be effective and safe in well-controlled, long-term trials, 8 and many persons with this disorder are not completely satisfied with their current treatment options. 4 Linaclotide is a 14-amino-acid synthetic peptide that is structurally related to the endogenous guanylin peptide family. It binds . . .