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Current treatment paradigm and landscape for the management of chronic idiopathic constipation in adults

Focus on plecanatide

Martinez de Andino, Nicole APRN (Specialty Nurse Practitioner)

Journal of the American Association of Nurse Practitioners: July 2018 - Volume 30 - Issue 7 - p 412–420
doi: 10.1097/JXX.0000000000000090
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Background and purpose: Chronic idiopathic constipation (CIC) is a prevalent disorder affecting productivity, quality of life, and health care resource utilization. Nurse practitioners (NPs) play a critical function in managing patients presenting with CIC, with roles including evaluation, diagnosis, treatment decisions, and patient education. For adults with inadequate response or tolerability issues using over-the-counter treatments, three prescription agents (plecanatide, linaclotide, and lubiprostone) are available in the United States to treat CIC, of which plecanatide was mostly recently approved. This review provides NPs with a current overview and summary of plecanatide in the current treatment landscape for CIC.

Methods: PubMed was searched for the literature regarding clinical practice guidelines and published trial data for lubiprostone, linaclotide, and plecanatide in CIC.

Conclusions: Efficacy and safety comparisons between prescription agents are limited beacause of the differences in trial duration and primary end points (all different). Generally, plecanatide and linaclotide demonstrated similar efficacy, with plecanatide demonstrating lower rates of adverse events.

Implications for practice: The success of CIC treatment can be affected by patient adherence to the regimen, which is dependent on the efficacy and tolerability of treatment. Plecanatide is a promising option for patients whose CIC symptoms are not adequately controlled using their current treatment approach.

Division of Gastroenterology/Hepatology, Department of Internal Medicine, Medical College of Georgia, Augusta University, Augusta, Georgia

Correspondence: Nicole Martinez de Andino, APRN, Neurogastroenterology and Motility, Digestive Health Center, Medical College of Georgia, Augusta University, 1481 Laney Walker Boulevard, Augusta, GA 30912; Tel: 706-723-0131; Fax: 706-723-0381; E-mail: nmartinezdeandino@augusta.edu

Funding: This review was funded by Synergy Pharmaceuticals Inc.

Competing interests: N. Martinez de Andino has participated in an advisory board for Synergy Pharmaceuticals Inc.

Received April 03, 2018

Received in revised form May 14, 2018

Accepted May 15, 2018

© 2018 American Association of Nurse Practitioners
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