Plecanatide
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Plecanatide

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Plecanatide, also called Trulance, a synthetic analogue of uroguanylin, is a guanylate cyclase-C (GCC) agonist being developed by Synergy Pharmaceuticals for the treatment of gastrointestinal disorders, such as chronic idiopathic constipation (CIC) and irritable bowel syndrome with constipation (IBS-C). In January 2017, an oral formulation of plecanatide received its first global approval in the USA for the treatment of adult patients with CIC. Besides, Plecanatide is undergoing phase III investigation in IBS-C. It had also undergone preclinical investigations in inflammatory bowel disease (IBD) and ulcerative colitis; however, development in these indications has been discontinued.

Category
Peptide Inhibitors
Catalog number
BAT-010091
CAS number
467426-54-6
Molecular Formula
C65H104N18O26S4
Molecular Weight
1681.89
Plecanatide
Size Price Stock Quantity
5 mg $299 In stock
IUPAC Name
(2S)-2-[[(1R,4S,7S,10S,13S,16R,19S,22S,25R,32S,38R)-10-(2-amino-2-oxoethyl)-25-[[(2S)-4-carboxy-2-[[(2S)-3-carboxy-2-[[(2S)-2,4-diamino-4-oxobutanoyl]amino]propanoyl]amino]butanoyl]amino]-22-(2-carboxyethyl)-32-[(1R)-1-hydroxyethyl]-4-methyl-19-(2-methylpropyl)-3,6,9,12,15,18,21,24,30,33,36-undecaoxo-7,13-di(propan-2-yl)-27,28,40,41-tetrathia-2,5,8,11,14,17,20,23,31,34,37-undecazabicyclo[14.13.13]dotetracontane-38-carbonyl]amino]-4-methylpentanoic acid
Synonyms
L-​Leucine, L-​asparaginyl-​L-​α-​aspartyl-​L-​α-​glutamyl-​L-​cysteinyl-​L-​α-​glutamyl-​L-​leucyl-​L-​cysteinyl-​L-​valyl-​L-​asparaginyl-​L-​valyl-​L-​alanyl-​L-​cysteinyl-​L-​threonylglycyl-​L-​cysteinyl-​, cyclic (4→12)​,​(7→15)​-​bis(disulfide); 105: PN: WO2012037380 SEQID: 105 claimed protein; 1: PN: US20100152118 SEQID: 1 claimed protein; 1: PN: WO2008151257 SEQID: 1 claimed protein; 1: PN: WO2010065751 SEQID: 1 claimed protein; 1: PN: WO2011069038 SEQID: 1 claimed sequence; 1: PN: WO2012037380 SEQID: 1 claimed protein; 1: PN: WO2014131024 SEQID: 1 claimed protein; 1: PN: WO2015054500 SEQID: 1 claimed protein; 1: PN: WO2015054649 SEQID: 1 claimed protein; 20: PN: WO02078683 SEQID: 20 claimed protein; 78: PN: WO2010065751 SEQID: 105 claimed protein; 7: PN: WO2015054500 SEQID: 105 claimed protein; 8: PN: WO2015054500 SEQID: 106 claimed protein; 9: PN: WO2015054500 SEQID: 107 claimed protein; SP 304; Trulance
Appearance
Amorphous, White to off-white powder
Density
1.47±0.1 g/cm3
Boiling Point
2120.0±65.0°C(Predicted)
Sequence
NDEC(1)ELC(2)VNVAC(1)TGC(2)L
Storage
Store at -20°C
Solubility
Soluble in water
Application
Guanylyl cyclase c agonists; gastrointestinal agents
InChI
1S/C65H104N18O26S4/c1-25(2)15-34-55(98)80-41-24-113-110-21-38(58(101)77-37(65(108)109)16-26(3)4)71-44(87)20-69-62(105)50(30(10)84)83-61(104)40(78-51(94)29(9)70-63(106)48(27(5)6)81-57(100)35(18-43(68)86)76-64(107)49(28(7)8)82-60(41)103)23-112-111-22-39(59(102)73-32(53(96)75-34)11-13-45(88)89)79-54(97)33(12-14-46(90)91)72-56(99)36(19-47(92)93)74-52(95)31(66)17-42(67)85/h25-41,48-50,84H,11-24,66H2,1-10H3,(H2,67,85)(H2,68,86)(H,69,105)(H,70,106)(H,71,87)(H,72,99)(H,73,102)(H,74,95)(H,75,96)(H,76,107)(H,77,101)(H,78,94)(H,79,97)(H,80,98)(H,81,100)(H,82,103)(H,83,104)(H,88,89)(H,90,91)(H,92,93)(H,108,109)/t29-,30+,31-,32-,33-,34-,35-,36-,37-,38-,39-,40-,41-,48-,49-,50-/m0/s1
InChI Key
NSPHQWLKCGGCQR-DLJDZFDSSA-N
Canonical SMILES
CC1C(=O)NC2CSSCC(C(=O)NC(C(=O)NC(C(=O)NC(CSSCC(NC(=O)CNC(=O)C(NC2=O)C(C)O)C(=O)NC(CC(C)C)C(=O)O)C(=O)NC(C(=O)NC(C(=O)NC(C(=O)N1)C(C)C)CC(=O)N)C(C)C)CC(C)C)CCC(=O)O)NC(=O)C(CCC(=O)O)NC(=O)C(CC(=O)O)NC(=O)C(CC(=O)N)N
1. Plecanatide: First Global Approval
Yahiya Y Syed, Zaina T Al-Salama Drugs . 2017 Apr;77(5):593-598. doi: 10.1007/s40265-017-0718-0.
Plecanatide (TrulanceTM) is an oral guanylate cyclase-C agonist that is being developed by Synergy Pharmaceuticals for the treatment of gastrointestinal disorders, such as chronic idiopathic constipation (CIC) and irritable bowel syndrome with constipation (IBS-C). It is a synthetic analogue of human uroguanylin, a 16 amino acid peptide that regulates ion and fluid transport in the gastrointestinal tract. In January 2017, plecanatide received its first global approval in the USA for the treatment of adult patients with CIC. Plecanatide is undergoing phase III investigation in IBS-C. This article summarizes the milestones in the development of plecanatide leading to this first approval in CIC.
2. Plecanatide for the treatment of chronic idiopathic constipation in adult patients
Gabrio Bassotti, Massimo Bellini, Paolo Usai Satta Expert Rev Clin Pharmacol . 2019 Nov;12(11):1019-1026. doi: 10.1080/17512433.2019.1670057.
Introduction. Chronic idiopathic constipation (CIC) is a functional gastrointestinal disorder that is associated with an increased healthcare cost and an abnormally poor quality of life. Plecanatide is a natural analog to the peptide agonist of the guanylate cyclase-C (GC-C) receptor, uroguanylin. The conversion of guanosine 5-triphosphate to cyclic guanosine monophosphate results in an increased bowel fluid secretion. Plecanatide is a promising new agent for CIC unresponsive to current therapeutic regimes.Areas covered. A comprehensive online search of Medline and the Science Citation Index was made using the keywords 'plecanatide', 'guanylate cyclase-C agonists', and 'constipation', in various combinations. We reviewed the pharmacodynamics, pharmacokinetics, and metabolism of this agent, and the most significant studies regarding the clinical efficacy and safety of plecanatide in CIC therapy.Expert opinion. Experimental studies showed that plecanatide was significantly better than placebo in reducing CIC severity, straining, stool consistency, bowel movements and quality of life. Apart from limited cases of diarrhea, no serious adverse events were reported. However, few data are available on its long-term safety. Furthermore, patients' affordability of plecanatide can be limited by its costs. Finally, this new agent with a different way of action can be proposed in patients refractory to common therapy.
3. Plecanatide for Treatment of Chronic Constipation and Irritable Bowel Syndrome
Bryan L Love Am J Med . 2019 May;132(5):572-575. doi: 10.1016/j.amjmed.2018.11.027.
Chronic idiopathic constipation and irritable bowel syndrome with constipation are commonly encountered in ambulatory patients, but limited options exist for patients with persistent or severe symptoms following treatment with nonprescription products. Plecanatide (Trulance, Synergy Pharmaceuticals, New York, NY) is a 16-amino acid peptide analog of uroguanylin that stimulates guanylate cyclase-C receptors to increase chloride and bicarbonate secretion into the intestine and prevents the absorption of sodium ions, thereby increasing the secretion of water into the lumen. The influx of additional fluid accelerates intestinal transit, softens the stool, and facilitates easier defecation. Plecanatide is the second guanylate cyclase-C receptor agonist to be approved by the US Food and Drug Administration for chronic idiopathic constipation and irritable bowel syndrome, but plecanatide is unique because its effects are limited to the proximal small bowel.
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