Linaclotide, a peptide agonist of specific receptors in the lumen of the gastrointestinal tract, accelerates colonic transit time. This medication has been used in individuals with chronic constipation, but has not been specifically studied in patients with cancer and cancer-related constipation symptoms.
Johnston, J.M., Kurtz, C.B., Drossman, D.A., Lembo, A.J., Jeglinski, B.I., MacDougall, J.E., . . . Currie, M.G. (2009). Pilot study on the effect of linaclotide in patients with chronic constipation. American Journal of Gastroenterology, 104, 125–132.
To evaluate the safety, tolerability, and efficacy of linaclotide in patients with chronic constipation.
Patients recorded data related to daily bowel habits and called into a voice response system daily to record their medications taken and bowel movements. Patients were randomized to receive 100, 300, or 1,000 mcg of linaclotide or placebo once daily in the morning, in the fasting state.
This was a randomized, double-blind, placebo-controlled, parallel group, phase IIA study.
Linaclotide appeared to improve symptoms of chronic constipation and was well-tolerated overall.
The usefulness of linaclotide for patients with cancer who have constipation is not yet known. This medication is a peptide that binds to specific receptors on the membrane of intestinal enterocytes and may increase efflux into the intestinal lumen with concomitant fluid secretion. Those effects may improve stool consistency and transit time. Nurses should be aware that a variety of new medications aimed at management of constipation with various mechanisms of action are being developed. Applicability to patients with cancer has not yet been studied.