Irritable Bowel Syndrome – Current Treatment – Detailed, Expanded Analysis: Treatment Algorithms: Claims Data Analysis | IBS with constipation (including IBS without diarrhea)

Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder characterized by alterations in motility, stool consistency and frequency, and urgency. It is classified into three subtypes: constipation predominant, diarrhea predominant, and mixed. ICD codes for IBS include a variety of subtypes; this analysis covers IBS-constipation (IBS-C) and IBS without diarrhea. Limited treatment options are available, and only a few drugs have secured FDA approval for IBS-C. Current treatments include antidepressants (off-label), motor stimulants (off-label), anticholinergic agents (off-label), guanylate cyclase-C agonists (Allergan’s Linzess and Synergy Pharmaceutical’s Trulance), bicyclic fatty acids (Takeda’s Amitiza and Par’s generic, lubiprostone), and sodium / hydrogen exchanger 3 (NHE3) inhibitors (Ardelyx’s Ibsrela). These treatments are all moderately effective in treating the disease. Zelnorm, a 5-HT4 receptor agonist, was relaunched in 2019 for women with IBS-C younger than age 65; however, it was recently removed from the market again, owing to business-related reasons.


  • What patient shares do key therapies and brands garner by line of therapy in newly diagnosed IBS-C (including IBS without diarrhea) patients? What are the quarterly trends in prescribing among recently treated and newly diagnosed IBS-C (including IBS without diarrhea) patients?
  • How has Ibsrela been integrated into the treatment algorithm, and what is its source of business? Have Linzness, Trulance, and the newly launched generic lubiprostone continued to gain patient share?
  • What percentage of IBS-C patients receive drug therapy within 365 days of diagnosis, and how quickly? What percentage of patients progress to later lines of therapy within 365 days of diagnosis?
  • What percentage of IBS-C patients are treated with monotherapy vs. combination therapy? What are the most commonly used combinations?
  • What are the product-level compliance and persistency rates among drug-treated patients?


Treatment Algorithms: Claims Data Analysis provides detailed, quantitative analysis of the treatment journey and brand usage across lines of therapy and overall using real-world, patient-level claims data so that marketers can accurately assess their source of business, benchmark usage against competitors, and quantify areas of opportunity for their marketed or emerging brand.

Markets covered: United States

Key companies: Allergan, Synergy Pharmaceuticals, Takeda, Alfasigma

Key drugs: Ibsrela, Linzess, Trulance, Amitiza, lubiprostone (generic), Zelnorm, dicyclomine, hyoscyamine sulphate / scopolamine, SSRIs, SNRIs, tricyclic antidepressants


The Treatment Algorithms dashboard is an interactive supplement to our PowerPoint-based claims data analysis reports and retains the full set of analyses included in the reports (i.e., newly diagnosed patients, recently treated patients, persistency, and compliance). The dashboard allows for easier navigation of data visualizations and provides more detailed analyses examining the flow of treatment regimens in newly diagnosed and recently treated patients.

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