Domperidone to Treat Symptoms of Gastroparesis: Benefits and Side Effects from a Large Single-Center Cohort

Schey, Ron; Saadi, Mohammed; Midani, Deena; Roberts, Aaron; Parupalli, Rahul; Parkman, Henry P.

doi:10.1007/s10620-016-4272-5

Cited by 56 publications

(53 citation statements)

References 27 publications

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“…Other studies have shown improvement in gastroparesis symptoms with domperidone therapy . Symptoms that have been reported as improving include nausea, vomiting, postprandial fullness, and early satiety.…”

Section: Discussionmentioning

confidence: 96%

“…Other studies have shown improvement in gastroparesis symptoms with domperidone therapy. 7,8,17,18 Symptoms that have been reported as improving include nausea, vomiting, postprandial fullness, and early satiety. The findings of this study largely agree with those studies, with the exception of vomiting.…”

Section: Discussionmentioning

confidence: 99%

“…One potential concern with the use of domperidone is prolongation of the EKG QTc interval and cardiac arrhythmia, especially at doses above 30 mg daily . In a recent study of the therapeutic effects of domperidone 10 mg TID in 115 patients with gastroparesis, 60% of patients reported symptom improvement with only 5 subjects experiencing QTc prolongation …”

Section: Introductionmentioning

confidence: 99%

“…[5][6][7] In a recent study of the therapeutic effects of domperidone 10 mg TID in 115 patients with gastroparesis, 60% of patients reported symptom improvement with only 5 subjects experiencing QTc prolongation. 8 Recently, there has been a move to evaluate the therapeutic response in gastroparesis clinical trials with daily symptom scores, [9][10][11] as they can capture daily variability in gastroparesis symptoms and reduce recall bias that may be present asking about symptoms over a 2 week period, as done in the conventional gastroparesis cardinal symptom index (GCSI) scoring. The GCSI-daily diary (GCSI-DD) is one such symptom instrument that meets the specifications of the FDA guidance for clinical trials in gastroparesis 9-11 : daily recording of symptom severity of nausea, early satiety, postprandial fullness, abdominal pain and recording number of vomiting episodes.…”

mentioning

confidence: 99%

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Therapeutic response to domperidone in gastroparesis: A prospective study using the GCSI‐daily diary

Heckert

Parkman

2017

Neurogastroenterology Motil

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Common symptoms of gastroparesis include nausea, vomiting, early satiety, postprandial fullness, and upper abdominal pain. Domperidone is used for treatment of gastroparesis. Daily symptom scoring may help document efficacy. Aim:To determine the effectiveness of domperidone for gastroparesis symptoms using the gastroparesis cardinal symptom index-daily diary (GCSI-DD) and to determine which symptoms improve and when with domperidone treatment.Methods: Symptomatic patients with diabetic or idiopathic gastroparesis were enrolled. Gastric emptying was performed using 4 hour scintigraphy. GCSI-DD recorded symptoms at baseline and during six weeks of treatment with domperidone 10 mg TID. GCSI-DD records severity of nausea, early satiety, postprandial fullness, upper abdominal pain, overall gastroparesis symptoms on a scale of 0 (no symptom) to 4 (very severe) and records the number of vomiting episodes per day.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Therapeutic response to domperidone in gastroparesis: A prospective study using the GCSI‐daily diary

Heckert

Parkman

2017

Neurogastroenterology Motil

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“…Metoclopramide and domperidone, a D2 dopamine receptor antagonist, are the most widely used drugs, but only metoclopramide is currently approved by the Food and Drug Administration (FDA) in the United States. This treatment has limited efficacy and carries a black-box warning for tardive dyskinesia [29,30]. This makes management more challenging, and patients frequently present with severe symptoms due to either progression of the disease or medications losing efficacy over time, turning the disease refractory to medical treatment [31].…”

Section: Summary Of Evidencementioning

confidence: 99%

Peroral endoscopic pyloromyotomy for gastroparesis: a systematic review and meta-analysis

et al. 2020

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Background and aim Gastric peroral endoscopic pyloromyotomy (G-POEM) is a new therapeutic option for refractory gastroparesis (GP). A systematic review and meta-analysis was conducted to assess the effectiveness of G-POEM in refractory GP. For the quality of evidence, we used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. Methods We performed a literature search using MEDLINE, Embase, Cochrane library, LILACS and the Science citation index for studies related to G-POEM from the inception of its technique through January 2019. We selected studies that analyzed the gastroparesis cardinal symptom index (GCSI) and 4-hour solid-phase gastric emptying scintigraphy (GES) before and after the procedure to verify the efficacy of G-POEM, the main outcome measured. An analysis was performed using RevMan 5.3. Results Ten studies comprising 281 patients were included in this systematic review. The pooled mean difference in GCSI following the procedure was 1.76 (95 % CI: [1.43, 2.08], I2 = 72 %). We also performed GCSI subgroup analysis by follow-up duration that showed a pooled mean difference of 1.84 (95 % CI: [1.57, 2.12], I2 = 71 %). The pooled mean difference in GES after the procedure was 26.28 (95 % CI: [19.74, 32.83], I2 = 87 %), corresponding to a significant drop in percentage values of the gastric retention 4-hour scintigraphy. Conclusion This meta-analysis demonstrates that G-POEM is effective and shows promising outcomes in the clinical response and gastric emptying scintigraphy for gastroparesis. Therefore, it should be considered in the management of refractory gastroparesis.

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Gastroparesis in the Hospital Setting

Rangan

Ukleja

2020

Nut in Clin Prac

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Gastroparesis (GP) is commonly seen in hospitalized patients. Refractory vomiting and related dehydration, electrolyte abnormalities, and malnutrition are indications for hospital admission. In addition, tube feeding intolerance is a common sign of gastric dysmotility in critically ill patients. The diagnosis and management of GP in the hospital setting can be quite challenging. Diagnostic tests are often deferred because of patient intolerance of the oral meal for standard scintigraphy or severity of the primary disease. The diagnosis of GP is often established on the basis of clinical scenario and risk factors for gastric motor dysfunction. Medical therapy in GP is directed toward controlling nausea and vomiting by prokinetic and antinausea medications and correcting nutrition risks or treating malnutrition with nutrition therapy. Enteral nutrition is the preferred nutrition intervention for patients with GP. Delayed gastric emptying in critically ill patients has a negative impact on the timely delivery of enteral feeding and meeting the energy and protein goals. Measures to improve gastric tolerance or provide feeding beyond the stomach are often needed, since early enteral nutrition has been an important target of therapy for critically ill patients. This review will address the current understanding of the mechanisms of GP and feeding intolerance in critical illness, diagnostic workup, drug therapies, and interventions to improve the provision of enteral nutrition in hospital settings when gastric dysmotility is present or suspected.

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Domperidone to Treat Symptoms of Gastroparesis: Benefits and Side Effects from a Large Single-Center Cohort

Cited by 56 publications

References 27 publications

Therapeutic response to domperidone in gastroparesis: A prospective study using the GCSI‐daily diary

Therapeutic response to domperidone in gastroparesis: A prospective study using the GCSI‐daily diary

Peroral endoscopic pyloromyotomy for gastroparesis: a systematic review and meta-analysis

Gastroparesis in the Hospital Setting

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