Abstract
The selective sodium hydrogen exchanger 3 (NHE3) inhibitor tenapanor is being developed by Ardelyx Inc. for the treatment of constipation-predominant irritable bowel syndrome (IBS-C) [under the tradename IBSRELA®] and for hyperphosphataemia in patients with chronic kidney disease (CKD) on dialysis or with end stage renal disease (ESRD). Based on positive results from the phase III T3MPO trial program, tenapanor was recently approved in the USA for the treatment of IBS-C in adults. This article summarises the milestones in the development of tenapanor leading to this first approval.
Similar content being viewed by others
References
US Food and Drug Administration. Ibsrela (tenapanor) tablets, for oral use: NDA approval letter. 2019. https://www.accessdata.fda.gov/drugsatfda_docs/appletter/2019/211801Orig1s000ltr.pdf. Accessed 22 Oct 2019.
AstraZenaca, Ardelyx. AstraZeneca and Ardelyx announce worldwide licensing deal for NHE3 Inhibitor Programme for complications of renal disease, including diabetes-induced renal disease [media release]. 8 Oct 2012. http://www.astrazeneca.com.
Ardelyx. IBSRELA (tenapanor) tablets, for oral use: US prescribing information. 2019. https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211801s000lbl.pdf. Accessed 22 Oct 2019.
Rosenbaum DP, Yan A, Jacobs JW. Pharmacodynamics, safety, and tolerability of the NHE3 inhibitor tenapanor: two trials in healthy volunteers. Clin Drug Investig. 2018;38(4):341–51.
Fouque D, Vervloet M, Ketteler M. Targeting gastrointestinal transport proteins to control hyperphosphatemia in chronic kidney disease. Drugs. 2018;78(12):1171–86.
Ardelyx. Ardelyx regains worldwide development and commercialization rights for its late-stage development candidate, tenapanor, and related portfolio of NHE3 compounds [media release]. 3 Jun 2015. http://www.ardelyx.com.
Ardelyx, Kyowa Hakko Kirin. Ardelyx and Kyowa Hakko Kirin announce license agreement for tenapanor for cardiorenal diseases in Japan [media release]. 28 Nov 2017. http://www.ardelyx.com.
Ardelyx. Ardelyx announces license agreement with Shanghai Fosun Pharmaceutical Industrial Development Company Limited for tenapanor in China [media release]. 11 Dec 2017. http://www.ardelyx.com.
Knight Therapeutics. Knight announces exclusive license agreement with Ardelyx for tenapanor [media release]. 19 Mar 2018. http://www.gudknight.com.
Ardelyx. Ardelyx and Knight collaborate to bring tenapanor to patients in Canada [media release]. 19 Mar 2018. http://www.ardelyx.com.
King AJ, Siegel M, He Y, et al. Inhibition of sodium/hydrogen exchanger 3 in the gastrointestinal tract by tenapanor reduces paracellular phosphate permeability. Sci Transl Med. 2018;10(456):1–17.
Li Q, King AJ, Liu L, et al. Tenapanor reduces IBS pain through inhibition of TRPV1-dependent neuronal hyperexcitability in vivo [abstract no. 484 and poster P2027]. Am J Gastroenterol. 2017;112(Suppl. 1):S255.
Johansson S, Rosenbaum DP, Ahlqvist M, et al. Effects of tenapanor on cytochrome P450-mediated drug-drug interactions. Clin Pharmacol Drug Dev. 2017;6(5):466–75.
Chey WD, Lembo AJ, Korner P, et al. Efficacy and safety of tenapanor in patients with constipation predominant irritable bowel syndrome: a 12-week, double-blind, placebo-controlled, randomized phase 3 trial [abstract no. 421]. Am J Gastroenterol. 2017;112(Suppl. 1):S226–S7.
Chey WD, Lembo AJ, Yan A, et al. Efficacy and safety of tenapanor in patients with constipation predominant irritable bowel syndrome: a 6-month, double-blind, placebo-controlled phase 3 trial (T3mpo-2) [abstract no. 885]. Gastroenterology. 2018;154(6 Suppl. 1):S-1362.
Chey WD, Lembo AJ, Rosenbaum DP. Tenapanor treatment of patients with constipation-predominant irritable bowel syndrome: a phase 2, randomized, placebo-controlled efficacy and safety trial. Am J Gastroenterol. 2017;112(5):763–74.
Block GA, Rosenbaum DP, Yan A, et al. Efficacy and safety of tenapanor in patients with hyperphosphatemia receiving maintenance hemodialysis: a randomized phase 3 trial. J Am Soc Nephrol. 2019;30(4):641–52.
Ardelyx. Ardelyx announces positive results from the pivotal phase 3 AMPLIFY study evaluating tenapanor in dialysis patients who have uncontrolled hyperphosphatemia despite phosphate binder treatment [media release]. 3 Sep 2019. http://www.ardelyx.com.
Block GA, Rosenbaum DP, Leonsson-Zachrisson M, et al. Effect of tenapanor on serum phosphate in patients receiving hemodialysis. J Am Soc Nephrol. 2017;28(6):1933–42.
Lembo A, Chey WD, Rosenbaum DP. An open label long-term safety trial (T3MPO-3) of tenapanor in patients With irritable bowel syndrome with constipation (IBS-C) [abstract no. 430 and poster P0338]. Am J Gastroenterol. 2018;113(Suppl.):S252.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Funding
The preparation of this review was not supported by any external funding.
Conflicts of interest
During the peer review process the manufacturer of the agent under review was offered an opportunity to comment on the article. Changes resulting from any comments received were made by the authors on the basis of scientific completeness and accuracy. A. Markham, a contracted employee of Adis International Ltd/Springer Nature, is responsible for the article content and declares no relevant conflicts of interest.
Additional information
Enhanced material for this AdisInsight Report can be found at https://doi.org/10.6084/m9.figshare.9999704.
This profile has been extracted and modified from the AdisInsight database. AdisInsight tracks drug development worldwide through the entire development process, from discovery, through pre-clinical and clinical studies to market launch and beyond.
Rights and permissions
About this article
Cite this article
Markham, A. Tenapanor: First Approval. Drugs 79, 1897–1903 (2019). https://doi.org/10.1007/s40265-019-01215-9
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40265-019-01215-9