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Ironwood and Forest to Present Linaclotide Data at Digestive Disease Week® 2013

  Ironwood and Forest to Present Linaclotide Data at Digestive Disease Week®

Business Wire

CAMBRIDGE, Mass. & NEW YORK -- May 14, 2013

Ironwood Pharmaceuticals, Inc. (NASDAQ: IRWD) and Forest Laboratories, Inc.
(NYSE: FRX) announced today they will present linaclotide-related data during
Digestive Disease Week® 2013 in Orlando, Fla., May 18 through May 21, 2013.
Among the data highlighted will be two oral presentations: one providing
insight into the GC-C/cGMP pathway in patients with IBS-C and another
describing the effects of linaclotide on inhibiting visceral pain, both based
on nonclinical studies.

The oral presentation titled “Mechanisms Underlying Linaclotide Induced
Inhibition of Colonic Nociception” (abstract #1602418) will be presented at
2:45 p.m. ET on Monday, May 20, 2013, in room 104A by Stuart Brierley, Ph.D.,
NHMRC Career Development Fellow and Head of the Visceral Pain Research Group,
Nerve-Gut Research Laboratory, Discipline of Medicine at the University of

The oral presentation titled “Alterations in the Guanylate Cyclase-C
Receptor/cGMP Pathway in Patients with Constipation Predominant Irritable
Bowel Syndrome” (abstract #1602470) will also be presented by Dr. Brierley at
8:45 a.m. ET on Sunday, May 19, 2013 in room 314A.

Also being presented are the following poster presentations:

Clinical Posters

Assessing Abdominal and Bowel Symptoms Using Adequate Relief Based Thresholds:
Results from 2 Phase 3 Trials of Linaclotide in Patients with Irritable Bowel
Syndrome with Constipation (abstract #1598133) on Monday, May 20, 2013, 8 a.m.
– 5 p.m. in Hall WA1, presented by Michael Camilleri, M.D., Professor of
Pharmacology, Physiology, and Medicine, Department of Gastroenterology and
Hepatology, Mayo Clinic

Determining the Minimum Duration for Initial Treatment with Linaclotide in
IBS-C Patients: Results from Pooled Phase 3 Trials (abstract #1596597) on
Sunday, May 19, 2013, 8 a.m. – 5 p.m. in Hall WA1, presented by William Chey,
M.D., Professor of Medicine, Director of the Gastrointestinal Physiology
Laboratory and Co-Director of the Michigan Bowel Control Program at the
University of Michigan

The Effect of Linaclotide on IBS-QOL Sexual Subscale Scores in Patients with
Irritable Bowel Syndrome with Constipation: Results from a Post hoc Analysis
of 2 Phase 3 Trials of Linaclotide (abstract #1598793), on Tuesday, May 21,
2013, 8 a.m. – 5 p.m. in Hall WA1, presented by Mark Currie, Ph.D., Senior
Vice President, Chief Scientific Officer and President of R&D, Ironwood
Pharmaceuticals Inc.

Health Economic & Outcomes Research Poster

Longitudinal Direct Medical Costs Associated with Irritable Bowel
Syndrome-Constipation and Chronic Idiopathic Constipation in a
Population-Based Sample over a 10-Year Period (abstract #1581789), on Sunday,
May 19, 2013, 8 a.m. – 5 p.m. in Hall WA1, presented by Linda Herrick, Ph.D.,
Associate Dean of Undergraduate Nursing, South Dakota State University

All data are embargoed until the time of presentation.

About Linaclotide

Linaclotide is a guanylate cyclase‐C (GC‐C) agonist that is thought to work in
two ways based on nonclinical studies. Linaclotide binds to the GC-C receptor
locally, within the intestinal epithelium. Activation of GC-C results in
increased intestinal fluid secretion and transit and a reduction in visceral
pain, which is thought to be mediated by decreased activity of pain-sensing
nerves. The clinical relevance of the effect on pain fibers in nonclinical
studies has not been established. Linaclotide is marketed by Ironwood and
Forest in the United States as LINZESS® and is indicated for the treatment of
adults with irritable bowel syndrome with constipation (IBS-C) or chronic
idiopathic constipation (CIC). Linaclotide was also approved by the European
Commission for the treatment of adults in the European Union with IBS-C and is
marketed under the brand name Constella® through a license agreement between
Ironwood and Almirall, S.A. Ironwood also has partnered with Astellas Pharma
Inc. for development and commercialization of linaclotide in Japan, and with
AstraZeneca for development and commercialization of linaclotide in China.

Important Safety Information

LINZESS is contraindicated in pediatric patients up to 6 years of age. Use
should be avoided in pediatric patients 6 through 17 years of age. In
nonclinical studies, administration of a single, clinically relevant adult
oral dose of linaclotide caused deaths in young juvenile mice.


  * LINZESS is contraindicated in pediatric patients up to 6 years of age.
  * LINZESS is contraindicated in patients with known or suspected mechanical
    gastrointestinal obstruction.

Warnings and Precautions

Pediatric Risk

  * LINZESS is contraindicated in pediatric patients up to 6 years of age. In
    nonclinical studies, deaths occurred within 24 hours in young juvenile
    mice (1 to 3 week-old mice; approximately equivalent to human pediatric
    patients less than 2 years of age) following administration of one or two
    daily oral doses of linaclotide.
  * Use of LINZESS should be avoided in pediatric patients 6 through 17 years
    of age. Linaclotide did not cause deaths in older juvenile mice
    (approximately equivalent to humans age 12 to 17 years). Although there
    were no deaths in older juvenile mice, given the deaths in young juvenile
    mice and the lack of clinical safety and efficacy data in pediatric
    patients, use of LINZESS should be avoided in pediatric patients 6 through
    17 years of age.


  * Diarrhea was the most common adverse reaction of LINZESS-treated patients
    in the pooled IBS-C and CIC double-blind placebo-controlled trials. Severe
    diarrhea was reported in 2% of LINZESS-treated patients. The incidence of
    diarrhea was similar in the IBS-C and CIC populations.
  * Patients should be instructed to stop LINZESS if severe diarrhea occurs
    and to contact their healthcare provider, who should consider dose

Adverse Reactions

  * In IBS-C clinical trials, the most common adverse reactions in
    LINZESS-treated patients (incidence ≥2% and greater than placebo) were
    diarrhea (20% vs 3% placebo), abdominal pain (7% vs 5%), flatulence (4% vs
    2%), headache (4% vs 3%), viral gastroenteritis (3% vs 1%) and abdominal
    distension (2% vs 1%).
  * In CIC clinical trials, the most common adverse reactions in
    LINZESS-treated patients (incidence ≥2% and greater than placebo) were
    diarrhea (16% vs 5% placebo), abdominal pain (7% vs 6%), flatulence (6% vs
    5%), upper respiratory tract infection (5% vs 4%), sinusitis (3% vs 2%)
    and abdominal distension (3% vs 2%).

Please see full Prescribing Information including Boxed Warning:

About Ironwood Pharmaceuticals

Ironwood Pharmaceuticals (NASDAQ: IRWD) is committed to the art and science of
making medicines, from discovery through commercialization. We’re focused on
three goals: transforming knowledge into medicines that make a difference for
patients, creating value that will inspire the continued support of our fellow
shareholders, and building a team that passionately pursues excellence. Our
first product, linaclotide, is approved in the United States and Europe. Our
pipeline priorities include exploring further opportunities for linaclotide,
leveraging our deep expertise in functional gastrointestinal disorders, and
advancing programs in other areas such as allergic conditions, cardiovascular
disease, central nervous system disorders and other conditions defined by
patient symptoms. Ironwood was founded in 1998 and is headquartered in
Cambridge, Mass. Connect with us at or on Twitter at to learn more about Ironwood. Information that
may be important to investors will be routinely posted in both these

About Forest Laboratories, Inc.

Forest Laboratories’ (NYSE: FRX) longstanding global partnerships and track
record developing and marketing pharmaceutical products in the United States
have yielded its well-established central nervous system and cardiovascular
franchises and innovations in anti-infective and respiratory,
gastrointestinal, and pain management medicine. The Company’s pipeline, the
most robust in its history, includes product candidates in all stages of
development across a wide range of therapeutic areas. The Company is
headquartered in New York, NY. To learn more, visit

About Digestive Disease Week (DDW)

Digestive Disease Week® (DDW®) is the largest international gathering of
physicians, researchers and academics in the fields of gastroenterology,
hepatology, endoscopy and gastrointestinal surgery. Jointly sponsored by the
American Association for the Study of Liver Diseases (AASLD), the American
Gastroenterological Association (AGA) Institute, the American Society for
Gastrointestinal Endoscopy (ASGE) and the Society for Surgery of the
Alimentary Tract (SSAT), DDW takes place May 18 – 21, 2013, at the Orange
County Convention Center, FL. The meeting showcases more than 5,000 abstracts
and hundreds of lectures on the latest advances in GI research, medicine and
technology. More information can be found at

Except for the historical information contained herein, this release contains
forward‐looking statements within the meaning of the Private Securities
Litigation Reform Act of 1995. These statements involve a number of risks and
uncertainties, including the potential that the presentations identified above
are not given at all or at the times or locations specified, in addition to
the risk factors listed from time to time in each of Forest’s and Ironwood’s
Annual Reports on Form 10‐K, Quarterly Reports on Form 10‐Q, and other SEC
filings. Neither Forest nor Ironwood undertakes any obligation to update these
forward-looking statements to reflect events or circumstances occurring after
this press release. These forward-looking statements speak only as of the date
of this press release. All forward‐looking statements are qualified in their
entirety by this cautionary statement.


Forest Laboratories, Inc.
Frank J. Murdolo, 212-224-6714
Vice President - Investor Relations
Ironwood Pharmaceuticals, Inc.
Media Relations:
Lisa Buffington, 617-374-5103
Investor Relations:
Meredith Kaya, 617-374-5082
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