Open label study of long-term effectiveness of cisapride in patients with idiopathic gastroparesis

Cisapride induces acetylcholine release in cells of the myenteric plexus, thus promoting gastrointestinal motility. We studied the effects of cisapride on 11 patients with idiopathic gastroparesis. All had negative gastrointestinal endoscopy, normal glucose, and took no drugs capable of influencing...

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Bibliographic Details
Published in:Digestive diseases and sciences 1994-07, Vol.39 (7), p.1395-1398
Main Authors: DWORKIN, B. M, ROSENTHAL, W. S, CASELLAS, A. R, GIROLOMO, R, LEBOVICS, E, FREEMAN, S, CLARK, S. B
Format: Article
Language:English
Subjects:
Adult
Anti-Ulcer Agents - therapeutic use
Biological and medical sciences
Cisapride
Digestive system
Female
Gastric Emptying - drug effects
Humans
Male
Medical sciences
Paresis - drug therapy
Paresis - physiopathology
Pharmacology. Drug treatments
Piperidines - therapeutic use
Stomach Diseases - drug therapy
Stomach Diseases - physiopathology
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Summary:Cisapride induces acetylcholine release in cells of the myenteric plexus, thus promoting gastrointestinal motility. We studied the effects of cisapride on 11 patients with idiopathic gastroparesis. All had negative gastrointestinal endoscopy, normal glucose, and took no drugs capable of influencing motility. Most (9/11) were prior metoclopramide treatment failures. Patients' symptoms were scored (0-60) for pain, satiety, bloating, nausea, vomiting, and heartburn. All underwent a solid gastric emptying study using a Technetium-99-labeled egg meal and received placebo prior to cisapride. There were 10 females and one male with a mean (+/- SE) age of 37.8 +/- 2.6 years. Disease duration was 7.9 +/- 2.8 years. The dose of cisapride was 30-60 mg/day and the duration of therapy was 12.6 +/- 2.6 months (range 2.5-25 months). The symptom score improved on cisapride from 30.9 +/- 3.6 to 14.4 +/- 2.7 (P < 0.002 signed rank test). Emptying half-time improved from 113 +/- 4 min to 94 +/- 6 min, and 46.9 +/- 2.4% food remaining at 120 min decreased to 35.5 +/- 3.6% (both P < 0.05). Emptying half-time in normals was 68 +/- 5 min with 16.9 +/- 2.9% remaining at 120 min. Nine of 11 patients gained weight, with a mean increase of 6.7 +/- 1.6 lb (range 2-12 lb). We conclude that cisapride significantly reduces gastrointestinal symptoms and promotes weight gain in patients with idiopathic gastroparesis and is associated with improvement in solid gastric emptying. The drug is useful in patients who previously failed metoclopramide.
ISSN:0163-2116
1573-2568
DOI:10.1007/BF02088039