Gut Liver.  2020 Sep;14(5):589-600. doi.org/10.5009/gnl19103.

Efficacy and Safety of Ghrelin Agonists in Patients with Diabetic Gastroparesis: A Systematic Review and Meta-Analysis

Affiliations
  • 1Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine,Seoul, Korea
  • 2Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine,Seoul, Korea
  • 3Department of Internal Medicine, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea

Abstract

Background/Aims
Ghrelin agonists are emerging proki-netic agents for treating gastroparesis. Although recent clini-cal trials have demonstrated their efficacy in patients with diabetic gastroparesis (DG), the impact of such agents on symptoms and gastric dysmotility remains unclear. We per-formed a systematic review and meta-analysis to evaluate the efficacy and safety of ghrelin agonists in patients with DG.
Methods
A search of common electronic databases (MEDLINE, Embase, and Cochrane Central Register of Con-trolled Trials) was preformed, using keyword combinations that referenced ghrelin and DG and retrieving all eligible ran-domized controlled trials (RCTs) of ghrelin agonists versus placebo in patients with DG. The primary outcome measure was the change in patient-reported overall gastroparesis symptom scores. Secondary outcomes included the change in gastric emptying time, specific symptoms related to gas-troparesis, and adverse events. A random-effects model was applied to all study outcomes. Heterogeneity among stud-ies was determined by the chi-square test and I 2 statistics.
Results
We selected six RCTs of patients with DG (n=557) for meta-analysis. Ghrelin agonist administration (vs pla-cebo) significantly improved overall gastroparesis symptoms (standardized mean difference, –0.34; 95% confidence interval, –0.56 to –0.13) and significantly improved symp-toms related to gastroparesis, including nausea, vomiting, early satiety, and abdominal pain. Adverse events recorded for ghrelin agonists and placebo did not differ significantly. There was no significant heterogeneity among eligible stud-ies.
Conclusions
Compared with placebo, ghrelin agonists are effective and well-tolerated for the treatment of DG.

Keyword

Diabetes mellitus; Gastroparesis; Ghrelin; Metaanalysis; Systematic review
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