Randomised clinical trial

Ghrelin agonist TZP-101 relieves gastroparesis associated with severe nausea and vomiting - Randomised clinical study subset data

John Wo, N. Ejskjaer, P. M. Hellström, R. A. Malik, J. C. Pezzullo, L. Shaughnessy, P. Charlton, G. Kosutic, R. W. McCallum

Research output: Contribution to journalArticle

54 Citations (Scopus)

Abstract

Aliment Pharmacol Ther 2011; 33: 679-688 Summary Background Limited therapeutic options exist for severe gastroparesis, where severe nausea and vomiting can lead to weight loss, dehydration and malnutrition due to inadequate caloric and fluid intake. TZP-101 (ulimorelin) is a ghrelin receptor agonist that accelerates gastric emptying and improves upper gastrointestinal symptoms in diabetic patients with gastroparesis. Aim To assess effects of TZP-101 in diabetic gastroparesis patients with severe nausea/vomiting and baseline severity scores of ≥3.5 (range: 0-5) on the Gastroparesis Cardinal Symptom Index (GCSI) Nausea/Vomiting subscale. Methods Patients were hospitalised and received four single daily 30-min infusions of one of six TZP-101 doses (range 20-600 μg/kg) or placebo. Efficacy was assessed by symptom improvement. Results At baseline, 23 patients had a mean severity score for GCSI Nausea/Vomiting of 4.45 ± 0.44. Statistically significant improvements over placebo occurred in the 80 μg/kg group for end of treatment changes from baseline in GCSI Nausea/Vomiting subscale (reduction in score of -3.82 ± 0.76, P = 0.011) and the GCSI Total score (-3.14 ± 0.78, P = 0.016) and were maintained at the 30-day follow-up assessment (-2.02 ± 1.63, P = 0.073 and -1.99 ± 1.33, P = 0.032 respectively). The proportion of days with vomiting was reduced significantly (P = 0.05) in the 80 μg/kg group (mean of 1.2 days of vomiting for four treatment days) compared with placebo (mean of 3.2 days of vomiting across 4 treatment days). Conclusions TZP-101 substantially reduced the frequency and severity of nausea and vomiting as well as overall gastroparesis symptoms. The results are consistent with gastrointestinal motility effects of TZP-101, supporting further investigation of TZP-101 in the management of severe gastroparesis.

Original languageEnglish (US)
Pages (from-to)679-688
Number of pages10
JournalAlimentary Pharmacology and Therapeutics
Volume33
Issue number6
DOIs
StatePublished - Mar 2011
Externally publishedYes

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Gastroparesis
Ghrelin
Nausea
Vomiting
Randomized Controlled Trials
Placebos
Ghrelin Receptor
Clinical Studies
ulimorelin
Gastrointestinal Motility
Gastric Emptying
Therapeutics
Energy Intake
Dehydration
Malnutrition
Weight Loss

ASJC Scopus subject areas

  • Pharmacology (medical)

Cite this

Randomised clinical trial : Ghrelin agonist TZP-101 relieves gastroparesis associated with severe nausea and vomiting - Randomised clinical study subset data. / Wo, John; Ejskjaer, N.; Hellström, P. M.; Malik, R. A.; Pezzullo, J. C.; Shaughnessy, L.; Charlton, P.; Kosutic, G.; McCallum, R. W.

In: Alimentary Pharmacology and Therapeutics, Vol. 33, No. 6, 03.2011, p. 679-688.

Research output: Contribution to journalArticle

Wo, John ; Ejskjaer, N. ; Hellström, P. M. ; Malik, R. A. ; Pezzullo, J. C. ; Shaughnessy, L. ; Charlton, P. ; Kosutic, G. ; McCallum, R. W. / Randomised clinical trial : Ghrelin agonist TZP-101 relieves gastroparesis associated with severe nausea and vomiting - Randomised clinical study subset data. In: Alimentary Pharmacology and Therapeutics. 2011 ; Vol. 33, No. 6. pp. 679-688.
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abstract = "Aliment Pharmacol Ther 2011; 33: 679-688 Summary Background Limited therapeutic options exist for severe gastroparesis, where severe nausea and vomiting can lead to weight loss, dehydration and malnutrition due to inadequate caloric and fluid intake. TZP-101 (ulimorelin) is a ghrelin receptor agonist that accelerates gastric emptying and improves upper gastrointestinal symptoms in diabetic patients with gastroparesis. Aim To assess effects of TZP-101 in diabetic gastroparesis patients with severe nausea/vomiting and baseline severity scores of ≥3.5 (range: 0-5) on the Gastroparesis Cardinal Symptom Index (GCSI) Nausea/Vomiting subscale. Methods Patients were hospitalised and received four single daily 30-min infusions of one of six TZP-101 doses (range 20-600 μg/kg) or placebo. Efficacy was assessed by symptom improvement. Results At baseline, 23 patients had a mean severity score for GCSI Nausea/Vomiting of 4.45 ± 0.44. Statistically significant improvements over placebo occurred in the 80 μg/kg group for end of treatment changes from baseline in GCSI Nausea/Vomiting subscale (reduction in score of -3.82 ± 0.76, P = 0.011) and the GCSI Total score (-3.14 ± 0.78, P = 0.016) and were maintained at the 30-day follow-up assessment (-2.02 ± 1.63, P = 0.073 and -1.99 ± 1.33, P = 0.032 respectively). The proportion of days with vomiting was reduced significantly (P = 0.05) in the 80 μg/kg group (mean of 1.2 days of vomiting for four treatment days) compared with placebo (mean of 3.2 days of vomiting across 4 treatment days). Conclusions TZP-101 substantially reduced the frequency and severity of nausea and vomiting as well as overall gastroparesis symptoms. The results are consistent with gastrointestinal motility effects of TZP-101, supporting further investigation of TZP-101 in the management of severe gastroparesis.",
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AU - Wo, John

AU - Ejskjaer, N.

AU - Hellström, P. M.

AU - Malik, R. A.

AU - Pezzullo, J. C.

AU - Shaughnessy, L.

AU - Charlton, P.

AU - Kosutic, G.

AU - McCallum, R. W.

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N2 - Aliment Pharmacol Ther 2011; 33: 679-688 Summary Background Limited therapeutic options exist for severe gastroparesis, where severe nausea and vomiting can lead to weight loss, dehydration and malnutrition due to inadequate caloric and fluid intake. TZP-101 (ulimorelin) is a ghrelin receptor agonist that accelerates gastric emptying and improves upper gastrointestinal symptoms in diabetic patients with gastroparesis. Aim To assess effects of TZP-101 in diabetic gastroparesis patients with severe nausea/vomiting and baseline severity scores of ≥3.5 (range: 0-5) on the Gastroparesis Cardinal Symptom Index (GCSI) Nausea/Vomiting subscale. Methods Patients were hospitalised and received four single daily 30-min infusions of one of six TZP-101 doses (range 20-600 μg/kg) or placebo. Efficacy was assessed by symptom improvement. Results At baseline, 23 patients had a mean severity score for GCSI Nausea/Vomiting of 4.45 ± 0.44. Statistically significant improvements over placebo occurred in the 80 μg/kg group for end of treatment changes from baseline in GCSI Nausea/Vomiting subscale (reduction in score of -3.82 ± 0.76, P = 0.011) and the GCSI Total score (-3.14 ± 0.78, P = 0.016) and were maintained at the 30-day follow-up assessment (-2.02 ± 1.63, P = 0.073 and -1.99 ± 1.33, P = 0.032 respectively). The proportion of days with vomiting was reduced significantly (P = 0.05) in the 80 μg/kg group (mean of 1.2 days of vomiting for four treatment days) compared with placebo (mean of 3.2 days of vomiting across 4 treatment days). Conclusions TZP-101 substantially reduced the frequency and severity of nausea and vomiting as well as overall gastroparesis symptoms. The results are consistent with gastrointestinal motility effects of TZP-101, supporting further investigation of TZP-101 in the management of severe gastroparesis.

AB - Aliment Pharmacol Ther 2011; 33: 679-688 Summary Background Limited therapeutic options exist for severe gastroparesis, where severe nausea and vomiting can lead to weight loss, dehydration and malnutrition due to inadequate caloric and fluid intake. TZP-101 (ulimorelin) is a ghrelin receptor agonist that accelerates gastric emptying and improves upper gastrointestinal symptoms in diabetic patients with gastroparesis. Aim To assess effects of TZP-101 in diabetic gastroparesis patients with severe nausea/vomiting and baseline severity scores of ≥3.5 (range: 0-5) on the Gastroparesis Cardinal Symptom Index (GCSI) Nausea/Vomiting subscale. Methods Patients were hospitalised and received four single daily 30-min infusions of one of six TZP-101 doses (range 20-600 μg/kg) or placebo. Efficacy was assessed by symptom improvement. Results At baseline, 23 patients had a mean severity score for GCSI Nausea/Vomiting of 4.45 ± 0.44. Statistically significant improvements over placebo occurred in the 80 μg/kg group for end of treatment changes from baseline in GCSI Nausea/Vomiting subscale (reduction in score of -3.82 ± 0.76, P = 0.011) and the GCSI Total score (-3.14 ± 0.78, P = 0.016) and were maintained at the 30-day follow-up assessment (-2.02 ± 1.63, P = 0.073 and -1.99 ± 1.33, P = 0.032 respectively). The proportion of days with vomiting was reduced significantly (P = 0.05) in the 80 μg/kg group (mean of 1.2 days of vomiting for four treatment days) compared with placebo (mean of 3.2 days of vomiting across 4 treatment days). Conclusions TZP-101 substantially reduced the frequency and severity of nausea and vomiting as well as overall gastroparesis symptoms. The results are consistent with gastrointestinal motility effects of TZP-101, supporting further investigation of TZP-101 in the management of severe gastroparesis.

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