Boeckxstaens G E, Bartelsman J F W M, Lauwers L, Tytgat G N J
Division of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands.
Am J Gastroenterol. 2002 Jan;97(1):194-7. doi: 10.1111/j.1572-0241.2002.05396.x.
Scleroderma is a multisystem disorder frequently resulting in disturbed GI motility. Although, especially early in the disease, symptomatic improvement is achieved with prokinetic agents, more severe GI manifestations of scleroderma may be difficult to treat, leading to parenteral feeding and hospitalization. Recently, a new serotonin (5-HT4) receptor agonist prucalopride was shown to have remarkable prokinetic properties, resulting in symptomatic improvement and increased frequency of defecation in patients with chronic functional constipation. Here we report two cases of scleroderma with GI manifestation in which previous prokinetic treatment failed, but where the patients were successfully treated with prucalopride. Our data suggest that prucalopride may be a promising and effective drug to treat GI motility disorders in scleroderma. However, further placebo-controlled double blind studies are needed for full documentation of the usefulness of prucalopride in patients with scleroderma.
硬皮病是一种多系统疾病，常导致胃肠动力紊乱。尽管在疾病早期，促动力药物可改善症状，但硬皮病更严重的胃肠道表现可能难以治疗，进而导致肠外营养和住院治疗。最近，一种新型5-羟色胺（5-HT4）受体激动剂普芦卡必利显示出显著的促动力特性，可改善慢性功能性便秘患者的症状并增加排便频率。在此，我们报告两例有胃肠道表现的硬皮病患者，此前促动力治疗无效，但使用普芦卡必利成功治愈。我们的数据表明，普芦卡必利可能是治疗硬皮病胃肠动力障碍的一种有前景且有效的药物。然而，需要进一步开展安慰剂对照双盲研究，以充分证明普芦卡必利对硬皮病患者的有效性。
