CCK-1 receptor blockade for treatment of biliary colic: a pilot study.
BACKGROUND
Loxiglumide is a potent and selective cholecystokinin-1 (CCK-1) receptor antagonist able to inhibit gall-bladder contraction.


OBJECTIVE
To assess the effect of CCK-1 receptor blockade on the pain of patients with biliary colic.


METHODS
Fourteen patients with biliary colic but no suspicion for acute cholecystitis, were randomly and blindly assigned to loxiglumide (50 mg i.v.) or hyoscine-N-butyl bromide (20 mg i.v.) treatment. Pain intensity was monitored by a Visual Analogue Scale. Patients with less than 80% response at 30 min, were retreated with a second injection of the same compound.


RESULTS
Reduction in pain score (mean +/- S.E.M.) was faster and significantly greater in patients treated with loxiglumide (n = 7) than in controls (n = 7): 88 +/- 7% vs. 47 +/- 12% after 20 min, P < 0.05; 92 +/- 6% vs. 49 +/- 13%, after 30 min, P < 0.05. Only one of seven patients treated with loxiglumide needed a second injection at 30 min (vs. six of seven controls, P < 0.05). No adverse effect was observed after either treatment.


CONCLUSIONS
Loxiglumide is highly effective in obtaining pain relief in patients with biliary colic. The analgesic effect of CCK-1 receptor blockade is superior to that of a conventional anticholinergic treatment.
Malesci
A
A
Department of Internal Medicine, University of Milan, Milano, Italy. alberto.malesci@unimi.it
Pezzilli
R
R
D'Amato
M
M
Rovati
L
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D001660:Biliary Tract Diseases / Q000188:drug therapy*; D003085:Colic / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010865:Pilot Projects; D011377:Proglumide / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D011949:Receptors, Cholecystokinin / Q000037:antagonists & inhibitors*
D011949:Receptors, Cholecystokinin; C053737:loxiglumide; D011377:Proglumide