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Pharmacologic treatments for gastroparesis
Michael Camilleri1, Kara J Jencks1
1Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota.
Pharmacological Reviews
|March 27, 2025
Summary
Gastroparesis, a motility disorder causing nausea and delayed gastric emptying, has limited effective treatments. This review explores current and needed pharmacologic strategies for managing gastroparesis symptoms.
Area of Science:
- Gastroenterology
- Neurogastroenterology
- Pharmacology
Background:
- Gastroparesis is a neurogastrointestinal motility disorder characterized by delayed gastric emptying and symptoms like nausea, vomiting, and abdominal pain.
- Pathophysiological mechanisms include hypomotility, pylorospasm, and visceral hypersensitivity.
- Common causes are idiopathic, diabetic, and postsurgical, with other factors including medications and neurodegenerative diseases.
Purpose of the Study:
- To review the pharmacologic management of gastroparesis.
- To discuss prokinetic and antiemetic agents, drugs targeting the pylorus, and neuromodulators.
- To highlight the unmet need for effective gastroparesis treatments, particularly for refractory cases.
Main Methods:
- Literature review of pharmacologic agents used in gastroparesis management.
- Analysis of drug classes including prokinetics, antiemetics, pyloric agents, and neuromodulators.
- Evaluation of drug efficacy and current treatment landscape.
Main Results:
- Current pharmacologic options for gastroparesis include prokinetic and antiemetic agents.
- Metoclopramide is the only FDA-approved medication for gastroparesis.
- Significant unmet needs exist for more efficacious treatments, especially for refractory gastroparesis.
Conclusions:
- Pharmacologic management of gastroparesis involves a range of agents, but options are limited.
- There is a critical need for novel and more effective medications to treat gastroparesis.
- Further research into gastroparesis pathophysiology and drug development is essential.