951d – Tradipitant, a Novel Nk-1 Receptor Antagonist, Significantly Improved Nausea and Other Symptoms of Gastroparesis: Results of a Multicenter, Randomized, Double-Blind, Placebo-Controlled Phase Ii Trial

Carlin, Jesse L.; Lieberman, Verna R.; Dahal, Arya; Keefe, Madison S.; Xiao, Changfu; Birznieks, Gunther; Polymeropoulos, Mihael H.

doi:10.1016/s0016-5085(19)40855-x

Cited by 7 publications

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“…Although the APRON Trial failed to show positive results on the primary end point of nausea, several other secondary end points showed improvement with aprepitant 128. More recently, tradipitant has been shown to meet the primary end point of improvement in nausea scores as well as nausea-free days and other secondary end points on GCSI and PAGI-SYM in a female-predominant population of patients with gastroparesis (60% IG, 40% DG) with moderate-to-severe nausea 129…”

Section: Introductionmentioning

confidence: 99%

Gastroparesis: a turning point in understanding and treatment

Grover

Farrugia

Stanghellini

2019

Gut

182

219

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Gastroparesis is defined by delayed gastric emptying (GE) and symptoms of nausea, vomiting, bloating, postprandial fullness, early satiety and abdominal pain. Most common aetiologies include diabetes, postsurgical and postinfectious, but in many cases it is idiopathic. Clinical presentation and natural history vary by the aetiology. There is significant morbidity and healthcare utilisation associated with gastroparesis. Mechanistic studies from diabetic animal models of delayed GE as well as human full-thickness biopsies have significantly advanced our understanding of this disorder. An innate immune dysregulation and injury to the interstitial cells of Cajal and other components of the enteric nervous system through paracrine and oxidative stress mediators is likely central to the pathogenesis of gastroparesis. Scintigraphy and 13C breath testing provide the most validated assessment of GE. The stagnant gastroparesis therapeutic landscape is likely to soon see significant changes. Relatively newer treatment strategies include antiemetics (aprepitant), prokinetics (prucalopride, relamorelin) and fundic relaxants (acotiamide, buspirone). Endoscopic pyloromyotomy appears promising over the short term, especially for symptoms of nausea and vomiting. Further controlled trials and identification of the appropriate subgroup with pyloric dysfunction and assessment of long-term outcomes are essential. This review highlights the clinical presentation, diagnosis, mechanisms and treatment advancements for gastroparesis.

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