Asha Mohammad Z, Khalil Sundos F H
Department of Internal Medicine, Dr Mohamad Amine Zbeib Polyclinic, Doha, Qatar.
Department of Pharmacology, University of Jordan, Doha, Qatar.
Sultan Qaboos Univ Med J. 2019 Nov;19(4):e291-e304. doi: 10.18295/SQUMJ.2019.19.04.004. Epub 2019 Dec 22.
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.
糖尿病性胃轻瘫（DG）的药物干预是患者管理的重要组成部分。本文旨在系统回顾DG现有的药物治疗方法，包括其疗效和安全性。通过几个在线数据库共识别出24项研究针对DG症状的药物疗效和/或安全性的随机临床试验（RCT）。其结果显示，甲氧氯普胺是唯一被批准用于加速胃排空和改善疾病症状的药物。然而，这种药物可能对心血管和神经系统有多种不良反应，而一种新的鼻内制剂可能会解决这些问题。对于没有心血管危险因素的患者，可接受的替代药物是口服多潘立酮；对于住院患者，可使用静脉注射红霉素。初步数据表明，瑞莫瑞林和普芦卡必利是已被证明有效且安全的新型候选药物。未来的RCT应基于统一的指南，采用通用的诊断方式，以揭示可靠和全面的结果。
