Any news from the prokinetic front?

Area of Science:

• Gastroenterology
• Clinical Pharmacology

Background:

• Prokinetic drugs accelerate gastric emptying.
• They are used in patients with gastric dysmotility and enteral feed intolerance to improve nutrition delivery.
• Benefit is often assumed from observational studies linking dysmotility to poor outcomes.

Purpose of the Study:

• To provide an update on recent studies and randomized controlled trials evaluating prokinetic drugs.
• To summarize findings on the efficacy and application of prokinetic agents.

Main Methods:

• Review of recently conducted studies.
• Analysis of randomized controlled trials (RCTs).
• Evaluation of evidence for prokinetic drug use in specific patient populations.

Main Results:

• Prokinetic drugs increase enteral nutrition delivery in specific patient groups.
• Current trials have not demonstrated improvement in patient-centered outcomes.
• Use of metoclopramide and erythromycin is based on surrogate physiological outcomes.

Conclusions:

• Establishing superiority of prokinetic drugs via RCTs with patient-centered outcomes may be challenging.
• Recent RCTs of alternative and novel prokinetic drugs have been completed.
• Further research is needed to clarify the role of prokinetics in patient care.