Effect of the motilin agonist KC 11458 on gastric emptying in diabetic gastroparesis.
BACKGROUND
KC 11458, a motilin agonist without antibiotic properties, accelerates gastric emptying in animals and healthy humans.


OBJECTIVE
To evaluate the acute effects of KC 11458 on gastric emptying in diabetic gastroparesis.


METHODS
Twenty-nine patients (6 type 1 and 23 type 2) with gastroparesis underwent assessments of: (i) gastric emptying of a solid/liquid meal using scintigraphy, (ii) glycaemic control (blood glucose at 0, 30, 60, 90 and 120 min during the gastric emptying measurement) and (iii) upper gastrointestinal and 'meal-related' symptoms (questionnaire), at baseline and after treatment with KC 11458 in a dose of 8 mg t.d.s., or placebo for 8 days.


RESULTS
KC 11458 had no statistically significant or clinically relevant effect on gastric emptying of either the solid intragastric retention at 100 min (T100) (P = 0.87) or liquid 50% emptying time (T50) (P = 0.17) components of the meal. KC 11458 slightly worsened (P = 0.04) upper gastrointestinal symptoms when compared with placebo. The magnitude of the change in solid gastric emptying correlated with the change in the blood glucose concentration (r = 0.49; P < 0.05).


CONCLUSIONS
KC 11458, in a dose of 8 mg t.d.s. for 8 days, does not accelerate gastric emptying in patients with diabetic gastroparesis. The absence of efficacy may relate to an effect of hyperglycaemia.
Russo
A
A
Department of Medicine, Royal Adelaide Hospital, University of Adelaide, Australia.
Stevens
J E
JE
Giles
N
N
Krause
G
G
O'Donovan
D G
DG
Horowitz
M
M
Jones
K L
KL
D001342:Autonomic Nervous System Diseases / Q000097:blood / Q000503:physiopathology; D001786:Blood Glucose / Q000378:metabolism; D003920:Diabetes Mellitus / Q000097:blood / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000097:blood / Q000503:physiopathology; D004917:Erythromycin / Q000031:analogs & derivatives* / Q000494:pharmacology; D005260:Female; D005746:Gastric Emptying / Q000187:drug effects*; D018589:Gastroparesis / Q000097:blood / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009037:Motilin / Q000037:antagonists & inhibitors*
D001786:Blood Glucose; C493967:KC 11458; D009037:Motilin; D004917:Erythromycin