Cited by 102Gastrointestinal motility and disordersGastroesophageal reflux and treatmentsDiabetes Treatment and Management

A Systematic Review of the Efficacy of Domperidone for the Treatment of Diabetic Gastroparesis

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Sugumar, Aravind, Singh, Amanpal, Pasricha, Pankaj Jay·2008·Clinical Gastroenterology and Hepatology

Abstract

Background & aims Despite being widely used in more than 20 countries for the treatment of diabetic gastroparesis for several decades, domperidone is approved only on an investigational basis in the United States. However, because its use is increasing, it is important for gastroenterologists in this country to understand its effectiveness in this condition. The literature on this subject varies considerably with respect to the methods and outcome measures, making a meta-analysis unfeasible.Methods Our objective was to systematically analyze studies of the efficacy of domperidone in diabetic gastroparesis, with a focus on their methodologic and scientific merit. Information from 28 trials (11 full articles and 17 abstracts) from 1981 to 2007 was analyzed.Results The average study quality score was 8.3 out of a possible 15 and the total sample size equaled 1016. Overall, 64% of the studies showed significant efficacy of domperidone on the improvement of symptoms. Sixty percent of the studies showed an efficacy in gastric emptying and 67% of the studies proved the drug effective in reducing hospital admissions.Conclusions Overall, our assessment is that there is level 3 evidence for the efficacy of domperidone in diabetic gastroparesis, leading to a grade C recommendation for its use in this condition. These results need to be interpreted very cautiously because of significant methodologic limitations of these studies, including the fact that most positive studies lacked a control arm. It is clear that larger and better-designed studies are needed to further validate the use of this drug in diabetic gastroparesis.

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Crossref · 10.1016/j.cgh.2008.02.065

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  • Domperidone has much less blood-brain barrier penetration than metoclopramide; it is used worldwide but not FDA-approved because of unconvincing efficacy data, though it has a good safety profile.

    “Domperidone, another D2-antagonist, has much less penetration through the blood-brain barrier when compared to metoclopramide. In use throughout the world, it has not been approved by the FDA, because of unconvincing efficacy data, although it possesses a good safety profile [61].”

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Research works printed but not linked: 12

  1. Barone JA. Domperidone: a peripherally acting dopamine2-recep- tor antagonist. Ann Pharmacother 1999;33:429 -440.
  2. Braun AP. Domperidone in the treatment of symptoms of delayed gastric emptying in diabetic patients. Adv Ther 1989;6:51-62.
  3. Kozarek R. Domperidone for symptomatic management of dia- betic gastroparesis in metoclopramide treatment failures. Adv Ther 1990;7:61-68.
  4. Bingaman S, Koch K. Long-term domperidone treatment for symptoms of gastroparesis in diabetic patients. Diabetes 1997; 46:1204.
  5. Miller M, Patterson D. Natural history of diabetic gastroparesis treated with cisapride or domperidone. Am J Gastroenterol 1991; 86:1316 -1316.
  6. Patterson DJ, Botoman VA, Kozarek RA, et al. Domperidone is effective long-term treatment for diabetic gastroparesis. Gastro- enterology 1991;100:A137.
  7. Patterson D, Koch K, Abell T, et al. A multicenter placebo-con- trolled study of domperidone in diabetic gastroparesis. Gastro- enterology 1993;104:A564.
  8. Patterson D, Meldrum N, Kozarek RM. Long-term efficacy of domperidone in patients with diabetes and symptoms of gastro- paresis. Diabetes 1997;46:490.
  9. Koch KL, Bingaman S, Stern RM. Withdrawal study of domperi- done vs placebo in diabetic patients: effect on upper gastroin- testinal symptoms and gastric myoelectrical activity. Gastroen- terology 1995;108:A630.
  10. Abell TL, Rashed H, Cutts T, et al. Autonomic function is a determinant of quality of life improvement in response to domp- eridone therapy. Diabetes 1997;46:1445.
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Authors
Sugumar, A., Singh, A., & Pasricha, P. J.
Affiliations
  • Mayo Clinic (US)
  • The University of Texas Medical Branch at Galveston (US)
  • Stanford Medicine (US)
Corresponding author
Pasricha, Pankaj Jay
Venue
Clinical Gastroenterology and Hepatology
Publisher
Elsevier BV
Published
2008-07
Volume
6
Issue
7
Pages
726-733
ISSN
1542-3565 (ISSN-L)
OpenAlex
W2069589846
Cited by
102
References
28
Citations by year
2026: 3 · 2025: 5 · 2024: 1 · 2023: 8 · 2022: 6 · 2021: 5 · 2020: 2 · 2019: 4 · 2018: 5 · 2017: 8 · 2016: 9 · 2015: 5 · 2014: 8 · 2013: 7 · 2012: 13
FWCI
0.72
Type
journal article
Language
en
Open access
Locations
  • Clinical Gastroenterology and Hepatology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
  • Health Sciences › Medicine › Gastroenterology › Gastroesophageal reflux and treatments
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Keywords
domperidone, diabetic gastroparesis, drug efficacy, gastric emptying, symptom improvement, hospitalization, study quality, level of evidence
MeSH terms
Clinical Trials as Topic, Domperidone, Humans, United States, Treatment Outcome, Gastroparesis, Diabetes Complications

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