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. 2019 Nov;19(4):e291-e304.
doi: 10.18295/SQUMJ.2019.19.04.004. Epub 2019 Dec 22.

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

Mohammad Z Asha  1 , Sundos F H Khalil  2
Affiliations

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

Mohammad Z Asha et al. Sultan Qaboos Univ Med J. 2019 Nov.

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

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Figures

Figure 1
Figure 1
A flowchart of the search process used to identify randomised clinical trials investigating the efficacy and/or safety of medications targeting diabetic gastroparesis symptoms (N = 24).
Figure 2
Figure 2
A summary of risk of bias assessment for the included randomised clinical trials (N = 24).
See this image and copyright information in PMC

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