Pharmacological Approaches to Diabetic Gastroparesis: A systematic review of randomised clinical trials

Mohammad Z. Asha, Sundos F.H. Khalil

Abstract


Pharmacological interventions of diabetic gastroparesis (DG) constitute an essential element of a patient’s management. This article aimed to systematically review the available pharmacological approaches of DG, including their efficacy and safety. A total of 24 randomised clinical trials (RCTs) that investigated the efficacy and/or safety of medications targeting DG symptoms were identified using several online databases. Their results revealed that metoclopramide was the only approved drug for accelerating gastric emptying and improving disease symptoms. However, this medication may have several adverse effects on the cardiovascular and nervous systems, which might be resolved with a new intranasal preparation. Acceptable alternatives are oral domperidone for patients without cardiovascular risk factors or intravenous erythromycin for hospitalised patients. Preliminary data indicated that relamorelin and prucalopride are novel candidates that have proven to be effective and safe. Future RCTs should be conducted based on unified guidelines using universal diagnostic modalities to reveal reliable and comprehensive outcomes.

Keywords: Gastroparesis; Diabetes Mellitus; Diabetes Complications; Randomized Controlled Trial; Metoclopramide; Domperidone; Relamorelin.


Full Text:

PDF


DOI: http://dx.doi.org/10.18295/squmj.2019.19.04.004

Refbacks

  • There are currently no refbacks.




Creative Commons License
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Sultan Qaboos University Medical Journal, College of Medicine and Health Sciences, Sultan Qaboos University, PO Box 35, Postal Code 123, Al-Khod, Muscat, Oman

ISSN (Print edition): 2075-051X ISSN (Internet edition): 2075-0528

Copyright SQUMJ 2019. This journal and its content is licensed under a Creative Commons Attribution No Derivatives 4.0 International license.

Flag Counter