Irritable bowel syndrome with constipation (IBS-C) is a common condition that affects the digestive system (the gut). Symptoms may include stomach cramps, bloating and constipation. The exact cause is unknown, and IBS-C is often a lifelong condition. While there is no cure, dietary changes and the use of medication can often help control symptoms. IBS-C has been linked to issues of digestion, stress, and a family history of the condition. IBS-C affects approximately 7-21% of the population globally and is a significant health care burden impacting health and quality of life of affected individuals. Treatment of IBS-C is particularly challenging as symptoms fluctuate over time and are often recurrent and resistant to administered drugs.
Tenapanor is an oral drug under development for the treatment of IBS-C. It acts directly in the gut to reduce absorption of sodium. Sodium increases fluid in the gut, loosening stool, and alleviating constipation. If licensed, tenapanor may offer an additional treatment option for IBS-C by increasing intestinal fluid content, accelerating gastrointestinal (GI) motility, and providing relief from symptomatic pain and discomfort. By acting directly in the gut, tenapanor also has a potential advantage of having minimal side effects.
Etrolizumab is a new monoclonal antibody (an immune protein) delivered by subcutaneous injection. The treatment works by targeting molecules called integrins to control the immune response and prevent the accumulation of immune molecules, which cause inflammation in individuals with a form of ulcerative colitis where inflammation is not mediated by a signalling protein called tumour necrosis factors (TNF) alpha (‘non-TNF-α’) and who are therefore intolerant to TNF blockers. This represents a new target group as current therapies focus mainly on anti-TNF inflammation. In one study, etrolizumab showed a greater reduction of intestinal lymphocyte infiltration in comparison to standard treatment.