Effect of domperidone therapy on gastroparesis symptoms results of a dynamic cohort study by NIDDK Gastroparesis Consortium

Authors: SAROSIEK, IRENE - Texas Tech University Health Science Center; VAN NATTA, MARK - Johns Hopkins University; PARKMAN, HENRY - Temple University; ABELL, THOMAS - University Of Louisville; KOCH, KENNETH - Wake Forest University; KUO, BRADEN - Massachusetts General Hospital; SHULMAN, ROBERT - Children'S Nutrition Research Center (CNRC); FARRUGIA, GIANRICO - Mayo Clinic College Of Medicine; GROVER, MADHUSUDAN - Mayo Clinic; HAMILTON, FRANK - National Institute Of Diabetes And Digestive And Kidney Diseases; PASRICHA, PANKAJ - Johns Hopkins University; YATES, KATHERINE - Johns Hopkins University; MIRIEL, LAURA - Johns Hopkins University; WILSON, LAURA - Johns Hopkins University; YAMADA, GORO - Johns Hopkins University; TONASCIA, JAMES - Johns Hopkins University; MCCALLUM, RICHARD - Texas Tech University Health Science Center

Submitted to: Clinical Gastroenterology and Hepatology
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 3/1/2021
Publication Date: 6/1/2021
Citation: Sarosiek, I., Van Natta, M., Parkman, H.P., Abell, T., Koch, K.L., Kuo, B., Shulman, R.J., Farrugia, G., Grover, M., Hamilton, F.A., Pasricha, P.J., Yates, K.P., Miriel, L., Wilson, L., Yamada, G., Tonascia, J., Mccallum, R.W. 2021. Effect of domperidone therapy on gastroparesis symptoms results of a dynamic cohort study by NIDDK Gastroparesis Consortium. Clinical Gastroenterology and Hepatology. 20:e452-e464. https://doi.org/10.1016/j.cgh.2021.05.063.
DOI: https://doi.org/10.1016/j.cgh.2021.05.063

Interpretive Summary: People who have very slow stomach emptying often suffer from nutritional deficiencies because they have problems eating enough. This study tested whether a medicine called domperidone can improve their symptoms. Although the effect was not large, the medication did improve symptoms related to slow stomach emptying. A larger study should be conducted that also incorporates individuals genetic polymorphisms and nutritional diet composition.

Technical Abstract: The use of domperidone (DOM) for gastroparesis (GP) remains controversial and limited. We aimed to present outcomes of DOM therapy for treatment of patients participating in the multicenter National Institute of Diabetes and Digestive and Kidney Diseases Gastroparesis Clinical Research Consortium (GpCRC) Registries (GpR). The GpCRC cohort consisted of patients with GP (75%) and with GP-like symptoms but with normal gastric emptying (25%). The DOM group initiated therapy during the 96 weeks of enrollment in GpR1 and GpR2. Patients who had previously taken or who were on DOM therapy at enrollment were excluded from this analysis. The control group did not use domperidone (non-DOM group) before or after enrollment. The following outcome measures were identified:change from baseline in Gastroparesis Cardinal Symptom Index total score, with 3 subscales, plus Gastroesophageal Reflux Disease and Patient Assessment of Upper Gastrointestinal Disorders–Quality of Life scores. Overall, of 748 patients, 181 (24%) were in the DOM group, whereas 567 were in the non-DOM group. Sixty-three percent of participants had idiopathic GP. At baseline, DOM patients compared with non-DOM patients were significantly younger, had lower body mass index, non-Hispanic ethnicity, a higher annual household income, lower narcotic utilization, lower supplemental and complimentary medication use, and were more likely to have delayed gastric emptying time, as well as worse nausea and fullness scores. Compared with non-DOM patients, DOM patients experienced moderate but significantly more improvement in GP outcome measures: Gastroparesis Cardinal Symptom Index total score (P=.003), nausea (P=.003), and fullness subscales (P=.005), upper abdominal pain score (P=.04), Gastroesophageal Reflux Disease score (P=.05), and Patient Assessment of Upper Gastrointestinal Disorders Quality of Life score (P=.05).