ClinicalTrials.gg
RecruitingNCT06460038Updated Feb 10, 2025

Tenapanor in Synucleinopathy-Related Constipation

A Phase 2 interventional study of Tenapanor and Placebo in Synucleinopathy and Parkinson's Disease, sponsored by Cedar Valley Digestive Health Center. Recruiting at 1 site in United States. Open to participants aged 50 Years to 89 Years. Per ClinicalTrials.gov, last updated 2025-02-10.

Primary conditionParkinson DiseaseRegistry: SynucleinopathiesReclassifiedWhy we changed it
Registry
Synucleinopathies — the first condition term the registry derived for this study.
ClinicalTrials.gg
Parkinson Disease
Why
  1. The study's listed conditions name Parkinson Disease, a narrower term within Synucleinopathies.
Confidence
High: the new condition is named in the study's own listed conditions. Of 351 hand-checked studies reclassified this way, 68% were exactly right and 84% in the right disease family; the registry's first term was right for 5% (measured 2026-10-21). How we classify →
Wrong?
Tell us the study's main condition →

Sponsored by Cedar Valley Digestive Health Center · Phase 2, Interventional, and Treatment

From the registry’s dates

  • Started Jan 2025; still recruiting 1 year 10 months later.
Phase
Phase 2
Study type
Interventional
Enrollment
30
Allocation
Randomized
Ages
50 Years to 89 Years
Sex
All
01

Study summary

Investigation of tenapanor as a potential treatment for synucleinopathy-associated constipation

Read the detailed description

Randomized, double-blind, placebo controlled trial of tenapanor vs. placebo for treating synucleinopathy-associated constipation in Parkinson\'s disease.

02

Conditions studied

  • Synucleinopathy
  • Parkinson's Disease

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Keywords

  • tenapanor
  • synucleinopathy
  • Parkinson's disease
  • constipation
03

In context

Parkinson Disease Reclassified

4,573 studies on the registry are indexed under Parkinson Disease; 1,086 are open to participants now.

This study's planned enrollment of 30 is below the median of 40 across 3,353 interventional studies indexed under Parkinson Disease.

Browse Parkinson Disease studies →

Lead sponsor

This is the only study on the registry with Cedar Valley Digestive Health Center as lead sponsor.

Compared within Parkinson Disease, this study's primary condition as ClinicalTrials.gg classifies it; the registry's first condition term is Synucleinopathies. The counts are of registry records indexed under each term, refreshed daily. How we classify →

04

Who can participate

Ages eligible
50 Years to 89 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Age 50-89 years.
  2. Diagnosis of PD within Hoehn and Yahr stages 1-3, confirmed by a neurologist per International Parkinson and Movement Disorder Society criteria.
  3. Average weekly stool frequency of ≤5 spontaneous bowel movements (SBMs) and ≤2 complete spontaneous bowel movements (CSBMs) over the past 6 months. These criteria will be verified during a 2-week screening period.
  4. Stool consistency ≤3 on the Bristol Stool Form Scale (BSFS). This criterion will be verified during a 2-week screening period.
  5. Agreement to use , if applicable.

Exclusion criteria

Exclusion Criteria

  1. Functional diarrhea or IBS-D/M based on Rome IV Criteria.
  2. Symptomatic structural GI abnormalities or inflammatory bowel disease.
  3. Significant hepatic ( or AST ≥ 2.5x the ) or renal (serum creatinine >2mg/dl) dysfunction.
  4. Pregnancy or lactation.
  5. Diagnosis of primary dyssynergic defecation by anorectal manometry.
Terms in these criteria, in plain language(3)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Investigator)
Enrollment
30 participants (estimated)

Study arms

  • Experimental
    Tenapanor

    Tenapanor 50 mg orally twice daily for 12 weeks

    Drug: Tenapanor

  • Placebo comparator
    Placebo

    Placebo orally twice daily for 12 weeks

    Drug: Placebo

Interventions

  • Inhibitor of NHE3

  • DrugPlacebo

    Placebo drug

06

What researchers measure

Primary outcomes

  1. Complete spontaneous bowel movements (CSBM)

    Our primary endpoint will be CSBM response, defined as an increase of at least one CSBM per week compared to baseline for at least 6 of the 12 treatment weeks. A CSBM is defined as a bowel movement that occurs naturally and is accompanied by a feeling of complete evacuation

    Time frame: 6 of 12 weeks

Secondary outcomes

  1. Abdominal pain and bloating response

    Decrease in severity score of at least 20% or more from baseline in 6 of 12 weeks (pain visual analog scale 1-10 where 10 is worst pain)

    Time frame: 6 of 12 weeks

  2. Calprotectin

    Decrease in fecal calprotectin by 20% or greater

    Time frame: Week 12

  3. Lipopolysaccharide binding protein

    Decrease in serum lipopolysaccharide binding protein by 20% compared to baseline

    Time frame: Week 12

  4. Complete spontaneous bowel movements (CSBM) continuous

    CSBM treated as a continuous variable. The investigators expect an increase of CSBMs in the treatment group compared to the placebo group. A CSBM is defined as a bowel movement that occurs naturally and is accompanied by a feeling of complete evacuation

    Time frame: Week 12

  5. Plasma zonulin

    Decrease in zonulin by 20% compared to baseline

    Time frame: Week 12

07

Study locations

1 of 1 sites recruiting
08

References and documents

Publications

  • Manfready RA, Engen PA, Verhagen Metman L, Sanzo G, Goetz CG, Hall DA, Forsyth CB, Raeisi S, Voigt RM, Keshavarzian A. Attenuated Postprandial GLP-1 Response in Parkinson's Disease. Front Neurosci. 2021 Jul 2;15:660942. doi: 10.3389/fnins.2021.660942. eCollection 2021. PubMed 34276285 ↗
  • Manfready RA, Forsyth CB, Voigt RM, Hall DA, Goetz CG, Keshavarzian A. Gut-Brain Communication in Parkinson's Disease: Enteroendocrine Regulation by GLP-1. Curr Neurol Neurosci Rep. 2022 Jul;22(7):335-342. doi: 10.1007/s11910-022-01196-5. Epub 2022 May 28. PubMed 35633466 ↗
  • Post Z, Manfready RA, Keshavarzian A. Overview of the Gut-Brain Axis: From Gut to Brain and Back Again. Semin Neurol. 2023 Aug;43(4):506-517. doi: 10.1055/s-0043-1771464. Epub 2023 Aug 10. PubMed 37562457 ↗
  • Hall DA, Voigt RM, Cantu-Jungles TM, Hamaker B, Engen PA, Shaikh M, Raeisi S, Green SJ, Naqib A, Forsyth CB, Chen T, Manfready R, Ouyang B, Rasmussen HE, Sedghi S, Goetz CG, Keshavarzian A. An open label, non-randomized study assessing a prebiotic fiber intervention in a small cohort of Parkinson's disease participants. Nat Commun. 2023 Feb 18;14(1):926. doi: 10.1038/s41467-023-36497-x. PubMed 36801916 ↗
  • 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 May;112(5):763-774. doi: 10.1038/ajg.2017.41. Epub 2017 Feb 28. PubMed 28244495 ↗
  • Chey WD, Lembo AJ, Yang Y, Rosenbaum DP. Efficacy of Tenapanor in Treating Patients With Irritable Bowel Syndrome With Constipation: A 26-Week, Placebo-Controlled Phase 3 Trial (T3MPO-2). Am J Gastroenterol. 2021 Jun 1;116(6):1294-1303. doi: 10.14309/ajg.0000000000001056. PubMed 33337659 ↗
  • Chey WD, Lembo AJ, Rosenbaum DP. Efficacy of Tenapanor in Treating Patients With Irritable Bowel Syndrome With Constipation: A 12-Week, Placebo-Controlled Phase 3 Trial (T3MPO-1). Am J Gastroenterol. 2020 Feb;115(2):281-293. doi: 10.14309/ajg.0000000000000516. PubMed 31934897 ↗

Individual participant data

Plan to share: Yes — De-identified participant data

Supporting information: Study protocol, Statistical analysis plan, Informed consent form, Clinical study report, Analytic code

Time frame: Data requests can be submitted starting 6 months after article publication and the data will be made accessible for up to 24 months. Data will be available upon request for 2 years following study publication.

Access criteria: Access to trial IPD can be requested by qualified researchers engaging in independent scientific research, and will be provided following review and approval of a research proposal and Statistical Analysis Plan (SAP) and execution of a Data Sharing Agreement (DSA).

Data sharing details ↗ · library.rush.edu

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Feb 10, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06460038
Lead sponsor
Cedar Valley Digestive Health Center
Collaborators
Ardelyx
Responsible party
Sponsor
First posted
Jun 14, 2024
Start date
Jan 1, 2025
Primary completion
Dec 2026 (estimated)
Completion
Mar 2027 (estimated)
Last update
Feb 10, 2025

Study contacts

Richard A. Manfready, MD, AM, FACP
Contact
rman@alum.mit.edu
(319) 235-5390
Harichandana Punukula, PharmD, MS
Contact
hpunukula@cvmspc.com
319-888-8270
Richard A. Manfready, MD, AM, FACP
principal investigator · Cedar Valley Digestive Health Center
Ravindra Mallavarapu, MD
study chair · Cedar Valley Digestive Health Center
Harichandana Punukula, PharmD, MS
study director · Cedar Valley Digestive Health Center

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drug tested here: Tenapanor

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