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No good treatments available for gastroparesis symptoms
Clinical Question
What medications are effective for treating the symptoms of gastroparesis?
Bottom line
There is a lack of effective treatments for gastroparesis; those that may be effective are not marketed in many countries. The go-to metoclopramide has weak evidence of a benefit on nausea and bloating but is not effective overall. 1a-
Reference
Study design: Meta-analysis (randomized controlled trials)
Funding: Self-funded or unfunded
Setting: Various (meta-analysis)
Synopsis
These researchers searched 3 databases, including Cochrane CENTRAL, as well as a clinical trials registry, conference proceedings, and reference lists of identified articles to identity 29 randomized controlled trials of treatments for the symptoms of gastroparesis. They included research in any language. Two researchers independently conducted the search, abstracted the articles, and assessed the quality of the research. They used network meta-analysis to compare results of different treatments that were not directly compared. Based on global symptom scores, only clebopride (Clanzoflat, Cleboril), a chemical cousin to metoclopramide, and domperidone were effective to a greater extent than placebo. Clebopride is not widely available and domperidone is not available the United States except as an investigational drug. There was no evidence of publication bias or heterogeneity, but study quality, overall, was low. In a single, small study of 44 patients, metoclopramide had a small effect on nausea and bloating.
Reviewer
Allen F. Shaughnessy, PharmD, MMedEd
Professor of Family Medicine
Tufts University
Boston, MA
Comments
Impact assessment
Excellent
treatment
the only meds that helps is CBD !
GASTROPARESIS
GOOD TO LEARN
No good treatments available for gastroparesis symptoms
Frustrating to read (and would be exasperating if I were a patient) that no medications seem to make a difference. I imagine almost all patients with known gastroparesis take at least one medication prescribed by well meaning physicians but one wonders if the treatment causes more adverse symptoms that it resolves.
No
No