12-Week Study of Plecanatide for CIC (The CIC3 Study)

This is a randomized, 12-week, double-blind, placebo-controlled, study in approximately 1350
adult male and female patients with CIC comparing 2 doses of plecanatide to placebo. The
study will be conducted at approximately 180 clinical study sites in the United States (US)
and Canada. The primary objective of the study is to evaluate the efficacy and safety of 3.0
and 6.0 mg of plecanatide administered once daily (QD) for 12 weeks in a population of
patients with CIC. The study population will include only patients without other causes of
constipation or other chronic conditions that could interfere with study assessments.
Patients may not take laxatives (with the exception of the study-provided rescue medication,
bisacodyl 5mg tablets), or a number of prohibited drugs that are known to cause constipation
or diarrhea, during study participation.

There are 6 scheduled study visits, including the screening and follow-up visits. The planned
duration of participation in this study will be 112 days and up to 155 days, with washout and
all visit windows considered.

Inclusion Criteria:

- Male or female aged 18-80, inclusive

- Meets modified Rome III criteria for functional chronic idiopathic constipation for at
least 3 months with symptom onset for at least 6 months

- Completed a colonoscopy in accordance with AGA colon cancer screening guidelines (5
years), with no clinically significant findings

- Willing to maintain a stable diet during the study

Exclusion Criteria:

- Loose stool (mushy) or watery (Bristol score 6 or 7) stool in the absence of any
laxative or prohibited medicine for > 25% of BMs during the 3 months prior to
screening visit OR during the 14 day pre-treatment assessment

- Active peptic ulcer disease, diabetes or hypertension not adequately treated or not
stable

- History of cathartic colon, laxative, enema abuse, or ischemic colitis

- Fecal impaction within 3 months of screening

- Patient has had /has any: diseases or conditions associated with constipation (GI or
CNS), structural abnormality of the GI tract or gastric bypass surgery, pelvic floor
dysfunction, pseudo-obstruction, active infectious gastritis, diverticulitis, anal
fissures or any disease or condition that can affect GI motility or defecation or can
be associated with abdominal pain

- Unexplained and clinically significant "alarm symptoms" including lower GI bleeding,
iron-deficiency anemia, weight loss or systemic signs of infection or colitis

- Major surgery, stroke or MI within 60 days of screening

- Participated in a previous plecanatide clinical trial