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Plecanatide

Phase 3FDA approved

Chronic Idiopathic Constipation | Small molecule | Gastrointestinal |Bausch Health Companies Inc.|Trials Updated: Oct 7, 2026

Plecanatide development status

FDA approval on record Jan 19, 2017 as Trulance
Approval holderSalix
ApplicationNDA208745
Highest phase Phase 3
Registered trials 12 across 1 sponsor since Sep 2011

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

Plecanatide target and mechanism

Molecular targetGUCY2C
Target classAgonist
ModalitySmall molecule

Also known as Trulance

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLED
Total Trials11
Total Enrollment11,536

FDA Designations

No designations recorded

Plecanatide clinical trials

Plecanatide · 11 trials · 5 indications

Phase 3 6Phase 2 5
NCT02706483Long Term Safety Study of PlecanatideIrritable Bowel Syndrome
COMPLETED2,272 Analytics
NCT02493452Second Plecanatide Study In Irritable Bowel Syndrome With Constipation (IBS-C)Irritable Bowel Syndrome Characterized by Constipation
COMPLETED1,135 Analytics
NCT02387359The Plecanatide Irritable Bowel Syndrome With Constipation Study (IBS-C)Irritable Bowel Syndrome Characterized by Constipation
COMPLETED1,054 Analytics
NCT0212247112-Week Study of Plecanatide for CIC (The National CIC3 Study)Chronic Idiopathic Constipation
COMPLETED1,410 Analytics
NCT0198224012-Week Study of Plecanatide for CIC (The CIC3 Study)Chronic Idiopathic Constipation
COMPLETED1,394 Analytics
NCT01919697Open-label Extension (OLE) Study of Plecanatide for Chronic Idiopathic Constipation (CIC)Chronic Idiopathic Constipation
COMPLETED2,370 Analytics
PHASE3COMPLETED
Long Term Safety Study of Plecanatide
Irritable Bowel SyndromeUnlock trial analytics
PHASE3COMPLETED
Second Plecanatide Study In Irritable Bowel Syndrome With Constipation (IBS-C)
Irritable Bowel Syndrome Characterized by ConstipationUnlock trial analytics
PHASE3COMPLETED
The Plecanatide Irritable Bowel Syndrome With Constipation Study (IBS-C)
Irritable Bowel Syndrome Characterized by ConstipationUnlock trial analytics
PHASE3COMPLETED
12-Week Study of Plecanatide for CIC (The National CIC3 Study)
Chronic Idiopathic ConstipationUnlock trial analytics
PHASE3COMPLETED
12-Week Study of Plecanatide for CIC (The CIC3 Study)
Chronic Idiopathic ConstipationUnlock trial analytics
PHASE3COMPLETED
Open-label Extension (OLE) Study of Plecanatide for Chronic Idiopathic Constipation (CIC)
Chronic Idiopathic ConstipationUnlock trial analytics

Study Endpoints

Primary Endpoints

Number of Participants With Treatment Related Adverse Events.
up to 53 weeks

Number of participants with adverse events with evidence to suggest a causal relationship between treatment and study drug.

Number of Overall Responders - ITT Population
12 weeks

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.

Number of Abdominal Pain Responders for at Least 6 of 12 Treatment Weeks
12 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.

Number of Stool Frequency Responder for at Least 6 of the 12 Treatment Weeks
12 Weeks

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.

Number of Durable Overall CSBM Responders, Mean Replacement Approach
12-Week Treatment Period

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.

Number of Durable Overall CSBM Responders , Mean Replacement Approach
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, 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.

Number of Patients With at Least One Treatment-Emergent Adverse Event (TEAE)
From first dose up to 72 weeks

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.

Number of Patients With at Least One Treatment-Emergent Adverse Event (TEAE) Leading to Discontinuation of Plecanatide
From first dose up to 72 weeks

Tolerability was evaluated based on number of patients who experienced at least one TEAE leading to discontinuation of the study drug

Summary of Vital Signs at >Day 364 - Blood Pressure (Systolic and Diastolic; mmHg)
From first dose up to 72 weeks

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).

Summary of Vital Signs at >Day 364 - Heart Rate (Beats Per Minute)
From first dose up to 72 weeks

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).

Summary of Vital Signs at >Day 364 - Body Temperature (°C)
From first dose up to 72 weeks

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).

Summary of Vital Signs at >Day 364 - Respiration Rate (Breaths Per Minute)
From first dose up to 72 weeks

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).

Summary of ECG Results Shift From Baseline at > Day 364
From first dose up to 72 weeks

Baseline was defined as the last non-missing value collected prior to first dose of study drug)

Summary of Treatment-Emergent Laboratory Abnormalities With At Least a 1-grade Shift From Baseline
From first dose up to 72 weeks

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.

Change From Baseline in Weekly Spontaneous Bowel Movement (SBM) Frequency at Week 8
Baseline to week 8

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.

Change From Baseline in Weekly Spontaneous Bowel Movement (SBM) Frequency Over the 4 Week Treatment Period Compared to Placebo and Across Treatment Groups
Baseline to Week 4

Weekly SBM rate computed for each week

Proportion of Overall Responders
8 weeks

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.

Change From Baseline in Weekly CSBMs Frequency Over the 12-Week Treatment Period (mITT Population)
12 weeks Treatment Period

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.

Overall Responder 9/12 Weeks
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 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.

Secondary Endpoints

Number of Sustained Efficacy Responders
12 Weeks
Change From Baseline in Stool Consistency
Baseline and 12-Week
Change From Baseline in Straining
Baseline and 12-Week
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Study Design & Arms

AllocationNA
MaskingNONE
ModelSINGLE_GROUP
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
PlecanatideEXPERIMENTALPlecanatide 6.0 mg tablets
3.0 mg plecanatideACTIVE_COMPARATORPlecanatide 3.0 mg dosed daily for 12 weeks
6.0 mg plecanatideACTIVE_COMPARATORPlecanatide 6.0 mg dosed daily for 12 weeks
Matching placeboACTIVE_COMPARATORPlacebo dosed daily for 12 weeks
Plecanatide 3.0 mgEXPERIMENTALPlecanatide tablets 3.0 mg QD for 12 weeks
PlaceboPLACEBO_COMPARATORMatching placebo tablets QD for 12 weeks
Plecanatide 6.0 mgEXPERIMENTALPlecanatide tablets 6.0 mg QD for 12 weeks
BisacodylOTHERRescue medication
Low Dose PlecanatideEXPERIMENTALParticipants will receive weight-based low-dose plecanatide administered orally once daily for 8 weeks.
High Dose PlecanatideEXPERIMENTALParticipants will receive weight-based high-dose plecanatide orally once daily for 8 weeks.
0.5 mg plecanatideEXPERIMENTALPlecanatide 0.5 mg Taken orally once daily for 4 weeks Group A: 6 to 11 years old
1.0 mg plecanatide - Group AEXPERIMENTALPlecanatide 1.0 mg Taken orally daily for 4 weeks Group A: 6 to 11 years old
2.0 mg plecanatideEXPERIMENTALPlecanatide 2.0 mg Taken orally daily for 4 weeks Group B: 12 to 18 Years of Age
Matching placebo - Group APLACEBO_COMPARATORMatching placebo Taken orally daily for 4 weeks Group A: 6 to 11 years old
1.0 mg plecanatide - Group BEXPERIMENTALPlecanatide 1.0 mg Taken orally daily for 4 weeks Group B: ≥ 12 to \< 18 Years of Age
Matching Placebo - Group BPLACEBO_COMPARATORMatching placebo Taken orally daily for 4 weeks Group B: 12 to \< 18 years old
Plecanatide 0.5 mgEXPERIMENTALTaken orally once daily in the morning for 8 weeks
Plecanatide 1.0 mgEXPERIMENTALTaken orally once daily in the morning for 8 weeks
Plecanatide 1.5 mgEXPERIMENTALTaken orally once daily in the morning for 8 weeks
Plecanatide 0.3mgACTIVE_COMPARATORPlecanatide 0.3mg, one tablet by mouth daily for 12 weeks
Plecanatide 1.0mgACTIVE_COMPARATORPlecanatide 1.0mg one tablet by mouth daily for 12 weeks
Plecanatide 3.0mgACTIVE_COMPARATORPlecanatide 3.0mg, one tablet by mouth daily for 12 weeks
Plecanatide 9.0mgACTIVE_COMPARATORPlecanatide 9.0mg, one tablet by mouth daily for 12 weeks
plecanatide 0.3 mgEXPERIMENTALSubjects receive plecanatide 0.3 mg for 12 consecutive weeks

Interventions

NameTypeDescription
PlecanatideDRUG -
PlaceboDRUG -
BisacodylDRUGRescue medication
Matching placeboDRUGTaken orally daily for 4 weeks
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Eligibility Criteria

Age Range18 Years to 85 Years
SexALL
Healthy VolunteersNo
Study Sites204

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...

Countries:United StatesCanada
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Recent Changes (Last 90 Days)

LOWOct 7, 2026NCT07723924lastUpdatePostDate: changed
LOWOct 7, 2026NCT07723924lastUpdatePostDate: changed
LOWOct 2, 2026NCT07723924Status: ACTIVE_NOT_RECRUITING → RECRUITING
LOWOct 2, 2026NCT07723924Status: ACTIVE_NOT_RECRUITING → RECRUITING
LOWJul 24, 2026NCT07723924NEW_TRIAL: changed
LOWJul 24, 2026NCT07723924NEW_TRIAL: changed

Frequently asked questions about Plecanatide

What is plecanatide used for?

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.

What does plecanatide target?

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.

Who makes plecanatide?

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.

What phase is plecanatide in?

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.

What clinical trials is plecanatide in?

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.

How many patients have been enrolled in plecanatide trials?

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.