Approval Probability
TA Base Rate
Adjusted LOA
ML Risk
Label indication TRULANCE is indicated in adults for the treatment of: chronic idiopathic constipation (CIC). irritable bowel syndrome with constipation (IBS-C). TRULANCE is a guanylate cyclase-C agonist indicated in adults for treatment of: chronic idiopathic constipation (CIC). ( 1 ) irritable bowel syndrome with constipation (IBS-C). ( 1 ) FDA label
Also known as Trulance
Plecanatide · 11 trials · 5 indications
Number of participants with adverse events with evidence to suggest a causal relationship between treatment and study drug.
An Overall Responder was a patient who was a weekly responder (i.e., decrease of 30% from baseline for abdominal pain intensity and an increase of at least 1 complete spontaneous bowel movement in the same week) for at least 6 of the 12 treatment weeks.
An Abdominal Pain Intensity Responder was a patient who had a decrease of 30 % from baseline for abdominal pain intensity. Baseline is the mean of non-missing abdominal pain scores recorded during the 2-week baseline diary assessment period prior to the first dose of study drug.
A Stool Frequency Responder was a patient who experienced an increase of at least one CSBM (complete spontaneous bowel movement) per week from baseline. Baseline was the mean number of CSBMs recorded during the 2-week baseline diary assessment period prior to the first dose of study drug.
The primary efficacy endpoint was measured by the number of durable overall CSBM responders over the 12-week Treatment Period. A durable overall CSBM responder was defined as a weekly CSBM responder for at least 9 of the 12 treatment weeks, including at least 3 of the last 4 weeks. A CSBM weekly responder was defined as a patient who has ≥ 3 Complete Spontaneous Bowel Movements (CSBMs) per week and an increase from baseline of ≥1 CSBM for that week. A CSBM was a bowel movement that occurred in the absence of laxative use within 24 hours and was associated with the feeling of complete evacuation.
A durable overall CSBM responder was defined as a weekly CSBM responder for at least 9 of the 12 treatment weeks, included at least 3 of the last 4 weeks. A CSBM weekly responder was defined as a patient who has ≥ 3 Complete Spontaneous Bowel Movements (CSBMs) per week and an increase from baseline of ≥1 CSBM for that week. A CSBM was a bowel movement that occurred in the absence of laxative use within 24 hours and was associated with the feeling of complete evacuation.
All clinically significant findings upon Physical Examinations of the Safety Population during the treatment period were reported as TEAEs. Safety was evaluated based on number of patients who experienced at least one TEAE.
Tolerability was evaluated based on number of patients who experienced at least one TEAE leading to discontinuation of the study drug
The vital signs included in the assessments were blood pressure (systolic and diastolic; mmHg), heart rate (beats per minute), body temperature (°C) and respiration rate (breaths per minute).
The vital signs included in the assessments were blood pressure (systolic and diastolic; mmHg), heart rate (beats per minute), body temperature (°C) and respiration rate (breaths per minute).
The vital signs included in the assessments were blood pressure (systolic and diastolic; mmHg), heart rate (beats per minute), body temperature (°C) and respiration rate (breaths per minute).
The vital signs included in the assessments were blood pressure (systolic and diastolic; mmHg), heart rate (beats per minute), body temperature (°C) and respiration rate (breaths per minute).
Baseline was defined as the last non-missing value collected prior to first dose of study drug)
Baseline was defined as the last non-missing value collected prior to first dose of study drug within a given entry into the study. The Common Terminology Criteria for Adverse Events (CTCAE), Grades 1 through 5 were used for descriptions of severity for each Adverse Event (AE): Grade 1 - Mild; asymptomatic or mild symptoms; clinical or diagnostic observations only; intervention not indicated; Grade 2 - Moderate; minimal, local or noninvasive intervention indicated; limiting age appropriate instrumental Activities of Daily Living (ADL); Grade 3 - Severe or medically significant but not immediately life-threatening; hospitalization or prolongation of hospitalization indicated; disabling; limiting self care ADL; Grade 4 - Life-threatening consequences; urgent intervention indicated; Grade 5 - Death related to AE.
Spontaneous bowel movements (SBMs) are defined as bowel movements that occur without the use of rescue medication within the preceding 24 hours. Weekly SBM frequency will be calculated based on daily electronic diary entries. The endpoint is the change from baseline in the number of SBMs per week at Week 8.
Weekly SBM rate computed for each week
An Overall Responder is a participant who was a Spontaneous Bowel Movement (SBM) responder for the last 2 weeks of the Treatment Period. An SBM responder is defined as a participant who had \>3 SBMs per week. SBM was defined as a bowel movement that occurs in the absence of laxative use within the preceding 24 hours. Participants missing with respect to the outcome measure were scored as non-responders.
The primary efficacy endpoint was the change from baseline in the weekly CSBM frequency (CSBMs per week minus CSBMs per week at baseline) over a 12-week Treatment Period. A Complete Spontaneous Bowel Movement (CSBM) is a Bowel Movement (BM) that occurs in the absence of laxative use within 24 hours of the BM and the patient reports a feeling of complete evacuation.
A Complete Spontaneous Bowel Movement (CSBM) is a Bowel Movement (BM) that occurs in the absence of laxative use within 24 hours of the BM and the patient reports a feeling of complete evacuation. A weekly responder will have 3 or more CSBMs and an increase of at least one CSBM from baseline in the same week. An overall responder is a patient who is a weekly responder for at least 9 of the 12 treatment weeks, including at least 3 of the last 4 weeks.
| Arm | Type | Description |
|---|---|---|
| Plecanatide | EXPERIMENTAL | Plecanatide 6.0 mg tablets |
| 3.0 mg plecanatide | ACTIVE_COMPARATOR | Plecanatide 3.0 mg dosed daily for 12 weeks |
| 6.0 mg plecanatide | ACTIVE_COMPARATOR | Plecanatide 6.0 mg dosed daily for 12 weeks |
| Matching placebo | ACTIVE_COMPARATOR | Placebo dosed daily for 12 weeks |
| Plecanatide 3.0 mg | EXPERIMENTAL | Plecanatide tablets 3.0 mg QD for 12 weeks |
| Placebo | PLACEBO_COMPARATOR | Matching placebo tablets QD for 12 weeks |
| Plecanatide 6.0 mg | EXPERIMENTAL | Plecanatide tablets 6.0 mg QD for 12 weeks |
| Bisacodyl | OTHER | Rescue medication |
| Low Dose Plecanatide | EXPERIMENTAL | Participants will receive weight-based low-dose plecanatide administered orally once daily for 8 weeks. |
| High Dose Plecanatide | EXPERIMENTAL | Participants will receive weight-based high-dose plecanatide orally once daily for 8 weeks. |
| 0.5 mg plecanatide | EXPERIMENTAL | Plecanatide 0.5 mg Taken orally once daily for 4 weeks Group A: 6 to 11 years old |
| 1.0 mg plecanatide - Group A | EXPERIMENTAL | Plecanatide 1.0 mg Taken orally daily for 4 weeks Group A: 6 to 11 years old |
| 2.0 mg plecanatide | EXPERIMENTAL | Plecanatide 2.0 mg Taken orally daily for 4 weeks Group B: 12 to 18 Years of Age |
| Matching placebo - Group A | PLACEBO_COMPARATOR | Matching placebo Taken orally daily for 4 weeks Group A: 6 to 11 years old |
| 1.0 mg plecanatide - Group B | EXPERIMENTAL | Plecanatide 1.0 mg Taken orally daily for 4 weeks Group B: ≥ 12 to \< 18 Years of Age |
| Matching Placebo - Group B | PLACEBO_COMPARATOR | Matching placebo Taken orally daily for 4 weeks Group B: 12 to \< 18 years old |
| Plecanatide 0.5 mg | EXPERIMENTAL | Taken orally once daily in the morning for 8 weeks |
| Plecanatide 1.0 mg | EXPERIMENTAL | Taken orally once daily in the morning for 8 weeks |
| Plecanatide 1.5 mg | EXPERIMENTAL | Taken orally once daily in the morning for 8 weeks |
| Plecanatide 0.3mg | ACTIVE_COMPARATOR | Plecanatide 0.3mg, one tablet by mouth daily for 12 weeks |
| Plecanatide 1.0mg | ACTIVE_COMPARATOR | Plecanatide 1.0mg one tablet by mouth daily for 12 weeks |
| Plecanatide 3.0mg | ACTIVE_COMPARATOR | Plecanatide 3.0mg, one tablet by mouth daily for 12 weeks |
| Plecanatide 9.0mg | ACTIVE_COMPARATOR | Plecanatide 9.0mg, one tablet by mouth daily for 12 weeks |
| plecanatide 0.3 mg | EXPERIMENTAL | Subjects receive plecanatide 0.3 mg for 12 consecutive weeks |
| Name | Type | Description |
|---|---|---|
| Plecanatide | DRUG | - |
| Placebo | DRUG | - |
| Bisacodyl | DRUG | Rescue medication |
| Matching placebo | DRUG | Taken orally daily for 4 weeks |
Inclusion Criteria: Patients with documented diagnosis of IBS-C who: * Completed plecanatide study SP304203-04 or SP304203-05, were compliant with the previous study's requirements, and did not experience any Serious Adverse Event (SAE) deemed related to study drug during the course of the previou...
Plecanatide is used to treat chronic idiopathic constipation, functional constipation, and irritable bowel syndrome with constipation. It is being studied in adults and in children and adolescents, including a Phase 2 program in patients aged 6 to less than 18 years with functional constipation or IBS-C.
Plecanatide targets GUCY2C, also known as guanylate cyclase C, and acts as an agonist at that receptor. By activating GUCY2C, the small molecule increases cyclic GMP signaling in the gut, which drives fluid secretion into the intestinal lumen and supports bowel movement.
Plecanatide is developed by Bausch Health Companies Inc., which trades under the ticker BHC. The company sponsors the clinical program across constipation and irritable bowel syndrome indications.
Plecanatide is in Phase 3 development for irritable bowel syndrome, with completed Phase 3 and Phase 2 trials in adults and pediatric patients. It remains an investigational agent in the studies tracked here rather than a newly approved product for these pediatric and IBS-C uses.
Plecanatide trials include NCT07723924, a recruiting Phase 2 study in children and adolescents aged 6 to under 18 with functional constipation, and the completed Phase 2 studies NCT03596905 in pediatric IBS-C and NCT03120520 in adolescents with chronic idiopathic constipation. The completed Phase 3 long-term safety study is NCT02706483.
Across the five tracked plecanatide trials, total enrollment is 6,249 participants. The largest is the completed Phase 3 long-term safety study NCT02706483 with 2,272 adults, while the pediatric studies are smaller, including 218 patients in NCT03596905 and 124 in NCT03120520.