Tenapanor Improves IBS-C Symptoms in Systematic Review and Meta-Analysis

Key Clinical Summary

• A systematic review and meta-analysis of 3 randomized controlled trials (1378 patients) found that tenapanor 50 mg significantly improved abdominal symptoms and complete spontaneous bowel movement (CSBM) responder rates compared with placebo in adults with irritable bowel syndrome with constipation (IBS-C). 
• Tenapanor was associated with higher rates of treatment-related adverse events and treatment discontinuation due to adverse events than placebo. 
• The authors concluded that tenapanor is effective for IBS-C symptom management but emphasized the need for additional studies to evaluate its long-term safety. 

Irritable bowel syndrome with constipation (IBS-C) is a common gastrointestinal disorder that can substantially impair quality of life. A systematic review and meta-analysis published in the European Journal of Gastroenterology &  Hepatology evaluated the efficacy and safety of tenapanor 50 mg for IBS-C and found significant improvements across multiple symptom domains compared with placebo, although treatment-related adverse events occurred more frequently.

Study Findings / Main News

The investigators performed a systematic review and meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Electronic databases, including PubMed, Cochrane, Embase, Scopus, and Web of Science, were searched to identify randomized controlled trials evaluating tenapanor in adults aged 18 to 75 years with IBS-C. Study quality was assessed using the Risk of Bias 2 tool.

Three randomized controlled trials comprising 1378 patients met the inclusion criteria. Compared with placebo, tenapanor significantly improved responder rates for multiple IBS-C symptoms, including abdominal bloating, cramping, discomfort, fullness, and pain. The treatment also significantly increased complete spontaneous bowel movement (CSBM) responder rates.

The meta-analysis also evaluated safety outcomes. Patients receiving tenapanor experienced more treatment-related adverse events than those receiving placebo. In addition, discontinuation because of adverse events occurred more frequently with tenapanor than with placebo.

Based on the pooled evidence, the investigators concluded that tenapanor provides clinically meaningful improvements in IBS-C symptoms while acknowledging the increased incidence of adverse events associated with treatment.

Clinical Implications

The findings support tenapanor as an effective treatment option for adults with IBS-C, demonstrating benefits across both bowel function and key abdominal symptoms that contribute substantially to disease burden. Improvements in pain, bloating, cramping, discomfort, fullness, and CSBM responder rates suggest that the therapy addresses multiple clinically relevant manifestations of IBS-C rather than constipation alone.

The investigators advised clinicians to consider the higher frequency of treatment-related adverse events and treatment discontinuations when discussing therapy with patients. They also noted that further research is needed to better characterize the long-term safety profile of tenapanor in patients with IBS-C.

Aref A, Aldemerdash MA, Mohamed I, et al. Efficacy and safety of tenapanor in the management of irritable bowel syndrome with constipation: a systematic review and meta-analysis. Eur J Gastroenterol Hepatol.2026;38(5):554-560. DOI:10.1097/MEG.0000000000003107