Tenapanor Linked to Lower IBS-C Care Use, With Kyle Staller, MD, MPH

Adults with irritable bowel syndrome with constipation (IBS-C) used fewer gastrointestinal (GI) health care resources in the year after starting tenapanor (Ibsrela). The data were presented at the American College of Gastroenterology (ACG) 2026 Annual Scientific Meeting.¹

The retrospective analysis included 470 patients from a national gastroenterology practice. Median GI-related health care resource utilization (HCRU) fell from 4.5 visits in the year before tenapanor initiation to 3.0 visits in the year after (P <.001).² Significant reductions were also seen among patients who had previously tried ≥1 IBS-C medication.

“We know that the vast majority of patients with IBS don’t necessarily present to a gastroenterologist, but among those that do, they really have a high degree of healthcare resource utilization, and I think we wonder: is that really a surrogate for dissatisfaction? That perhaps these patients are utilizing resources because they’re not happy with the current plan of care,” Kyle Staller, MD, MPH, director of the Gastrointestinal Motility Laboratory at Massachusetts General Hospital and first author of the analysis, said in an interview with HCPLive.

How Tenapanor’s Mechanism Differs From IBS-C Secretagogues

Most existing IBS-C therapies are secretagogues. They actively secrete ions into the intestinal lumen, and water follows to produce bowel movements.

Tenapanor is a locally acting inhibitor of sodium/hydrogen exchanger 3 (NHE3). It reduces sodium absorption in the small intestine and colon, which keeps water in the lumen and softens stool.² Staller described the drug as a retainagogue rather than a secretagogue.

The different mechanism and the drug’s newness on the market prompted the investigators’ question: would patients starting tenapanor de novo show a change in HCRU?

Median GI Visits Fell From 4.5 to 3.0 After Tenapanor Initiation

Eligible patients had ≥1 year of data before and after starting tenapanor and ≥1 outpatient visit, according to Staller. The analysis drew on electronic health records rather than billing codes alone.

The interquartile range for GI-related HCRU narrowed from 2 to 9 before initiation to 1 to 6 after.² The reductions held in subgroups regardless of body mass index or comorbidity burden.

Staller said the decline was most notable in office visits. He said this could reflect patients who feel more satisfied and no longer return to report ongoing symptoms.

Before and After Design Limits Causal Conclusions on Tenapanor

“I’m very confident that that reduction is real. I’m not sure that we can definitively say that that reduction is because they started tenapanor, but I think you do have to wonder, right? The patient starts tenapanor, and that reduction is very clear,” Staller said.

The analysis compared each patient’s use before and after initiation without a separate comparison group. Staller noted that factors other than tenapanor could contribute to the decline.

He also pointed to the data source as a strength. Patients came from large community GI practices across the country rather than the academic centers that typically supply this type of research.

Editor's note: Staller reports disclosures with AbbVie, Ardelyx, Gemelli, Salix, and Takeda.

References

1. Staller K, Fossa A, O’Byrne M, Scott LL. Health care resource utilization decreases among patients with constipation predominant irritable bowel syndrome following initiation of tenapanor: a real-world analysis. Poster P3082. Presented at: ACG 2026 Annual Scientific Meeting; October 12, 2026.

2. Ardelyx presents real-world data at ACG 2026 showing reduced healthcare resource utilization following IBSRELA initiation in adults with IBS-C. News release. Ardelyx. October 12, 2026.