Gastroparesis Clinical Trial
Official title:
Prucalopride Versus Placebo in Functional Dyspepsia With Delayed Gastric Emptying
Controlled cross-over study of prucalopride 2 mg daily or placebo in gastroparesis (idiopathic or diabetic). Patients will be randomized to 4 week treatment with the first regimen (double-blind), followed by a 2-week washout and 4 week treatment with the second regimen in cross-over.
To assess the influence of prucalopride (Resolor®) 2mg daily, 30 patients with idiopathic
and 30 patients with diabetic gastroparesis will undergo two gastric emptying breath tests
with concomitant assessment of meal-related symptoms, at the conclusion of two consecutive,
4-week treatment periods of prucalopride or placebo. The order of prucalopride and placebo
treatment will be randomised at the initiation of the study. Medication for both patient
groups, 30 patients with idiopathic and 30 patients with diabetic gastroparesis, will be
randomized separately. Half of the subjects will receive placebo first; the other half will
receive prucalopride first. Treatment periods will be separated by a wash-out period of 2
weeks. All drugs potentially affecting gastrointestinal motility or sensitivity will be
discontinued at least two weeks prior to the initiation of the study. Informed consent will
be obtained from each participant.
In order to establish the gastrointestinal symptom and quality-of-life profile of this
cohort, each patient will complete the following validated self-reported instruments at
baseline and at each of the two testing visits (table 1): Patients assessment of
Gastrointestinal symptoms (PAGISYM), Patients assessment of Gastrointestinal Quality of Life
Impact (PAGIQoL) Gastrointestinal and Global Severity Score, Patient Health Questionnaire
(PHQ-15), Appetite Questionnaire, Hospital Anxiety and Depression Scale, Visceral
Sensitivity Index, Short Form Nepean Dyspepsia Index (SF-NDI). The PAGI-SYM is a
comprehensive questionnaire of upper GI symptoms, and it includes a gastroparesis
questionnaire module: the Gastroparesis Cardinal Symptom Index (GCSI), which has been
validated in (idiopathic) gastroparesis.26 Furthermore, during the entire study duration
patients will complete a daily symptom diary, incorporating a separate horizontal 100-mm
visual analogue scale (VAS) for each of 9 upper abdominal symptoms. As prucalopride has a
well-known therapeutic effect in chronic constipation, patients will also register
information about their stool frequency and stool type in the daily diary (Bristol Stool
Scale).
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Crossover Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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