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Linaclotide effective against pediatric functional constipation

Dr. Hyams, MD, discusses functional constipation in children and how positive results from a phase 3 trial on linaclotide will change treatment.

In this interview, Jeffry Hyams, MD, pediatric gastroenterologist, discussed the effects of functional constipation (FC) and how positive phase 3 results of a trial on linaclotide indicate improved treatment of FC in pediatric patients.

FC is one of the most common gastroenteric conditions in children, according to Hyams. It causes infrequent, difficult stooling, leading to abdominal pain, discomfort, and potential soiling.

Change in diet is a common treatment for FC, which can prove difficult in cases where children are resistant toward changing what they eat. Osmotic agents are used as a medical treatment, as they can hold water in the stool. PEG 3350 is the most common agent, taken orally. This also sees resistance from children, many of which do not like taking medicine.

“Linaclotide is a huge step forward for us,” Hyams said. It decreases electrolytes and sentry perception, reducing the cramping patients with FC experience. Linaclotide would also be administered as a liquid or pill with small volume, making it easier to administer to children.

Hyams hopes treatment will be easier for both parents and patients, with cost-effective doses properly administered based on children’s sizes. Agents are often more expensive, meaning that linaclotide can reduce cost and increase accessibility.

About 4 to 6 million children aged 6 to 17 years are affected by FC annually. Linaclotide will aid many of these children based on its successful phase 3 trial. Both the primary outcome, 12-week spontaneous bowel movement frequency rate, and the secondary outcome, stool consistency, were met.

FC can have a major impact on children's lives, but many care providers are experienced in treating the condition and informing both parents and patients on symptoms and treatment.

“The majority of children do not have any serious underlying disease,” Hyams said. He reminded parents that a conversation with a health care provider or specialist can reduce confusion surrounding FC.