Constipation-predominant irritable bowel syndrome: A review of current and emerging drug therapies

Table 5 Chemical and clinical characteristics of bile acid modulators

	Chenodeoxycholate	Elobixibat
Chemical structure	Sodium chenodeoxycholic acid (primary bile acid)	Enantiomer of 1,5-benzothiazepine
Mechanism of action	Deconjugation to secondary bile acids, thus inducing colonic secretion and propulsive contractions	IBAT inhibition resulting in delivery of endogenous bile acids to the colon, thus inducing colonic secretion and propulsive contractions
Pharmacodynamic effects	Accelerated colonic transit	Dose-dependent acceleration of colonic transit
Most common adverse events	Diarrhea	Diarrhea
	Abdominal cramping/pain	Abdominal cramping/pain
	Nausea
Potential other beneficial effects	Probable lowering of LDL	Lowering of LDL and cholesterol
Stage of development	Phase 3 RCT in IBS-C completed	Phase 3 RCTs in CC, completed; extended safety and tolerability RCTs enrolling

CC: Chronic constipation; IBAT: Ileal bile acid transporter; IBS-C: Constipation-predominant irritable bowel syndrome; LDL: Low-density lipoprotein; RCT: Randomized controlled trial.