Plecanatide (Trulance)
Overview
A synthetic 16-amino acid peptide structurally related to uroguanylin, an endogenous intestinal peptide that regulates fluid and electrolyte homeostasis in the GI tract. Plecanatide activates guanylate cyclase-C (GC-C) receptors on intestinal epithelial cells in a pH-dependent manner, preferentially in the proximal small intestine where pH is slightly acidic.
Mechanism of Action
GC-C activation increases intracellular and extracellular cGMP, stimulating chloride and bicarbonate secretion while reducing visceral pain signaling.
Research Summary & Key Findings
FDA-approved in 2017 for chronic idiopathic constipation (CIC) and irritable bowel syndrome with constipation (IBS-C). Phase 3 trials showed significant improvement in complete spontaneous bowel movements and abdominal symptoms vs. placebo. Designed to mimic uroguanylin's pH-dependent activation, potentially reducing small bowel diarrhea compared to linaclotide. Generally well-tolerated with diarrhea as the most common adverse event.
Clinical Status
Plecanatide (Trulance) has received FDA approval and is available for clinical use under appropriate medical supervision. Consult a qualified healthcare provider for prescribing information.
Administration Routes
References
Primary literature
- PubMed — "Plecanatide"
Peer-reviewed literature indexed by the National Library of Medicine.
- ClinicalTrials.gov — "Plecanatide"
Registered interventional and observational studies, including status and phase.
- PubChem — "Plecanatide"
Chemical structure, molecular properties, and bioactivity data.
Study-level citations for this compound are being verified against the primary sources before publication. The database queries above return the current indexed literature in the meantime.
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