title: Relamorelin Reduces Vomiting Frequency and Severity and Accelerates Gastric Emptying in Adults With Diabetic Gastroparesis.
abstract: Gastroparesis is an important complication of diabetes. We investigated the effects of relamorelin (a pentapeptide-selective agonist of the ghrelin receptor that speeds gastric emptying in patients with diabetes) in patients with diabetic gastroparesis.
  
  
  
  We performed a double-blind trial of 204 patients (78% Caucasian; 67% female; mean age, 55 y; 88% with type 2 diabetes) with diabetic gastroparesis with moderate to severe symptoms and delayed gastric emptying at 27 clinical centers, from June 2012 until August 2013. Patients were assigned randomly (1:1:1) to groups given placebo or subcutaneous relamorelin 10 μg once or twice daily. The primary end point was the half-time of gastric emptying. Secondary end points included nausea, abdominal pain, bloating, early satiety, as well as the composite score of these 4 subjective symptoms and vomiting frequency and severity.
  
  
  
  Twice-daily relamorelin significantly accelerated gastric emptying (P < .03) and reduced vomiting frequency (by ∼60%) and severity vs placebo (P ≤ .033). Compared with placebo, relamorelin did not improve other gastrointestinal symptoms, such as abdominal pain and satiety. In the 119 patients (58.3%) with baseline vomiting, twice-daily relamorelin significantly reduced the half-time of gastric emptying and vomiting, as well as nausea, abdominal pain, bloating, and early satiety compared with placebo (composite score, P = .043). No overall safety concerns were identified.
  
  
  
  In a clinical trial of patients with diabetic gastroparesis, relamorelin (10 μg twice daily) significantly accelerated gastric emptying and significantly reduced vomiting, compared with placebo. Among patients with baseline vomiting, relamorelin had prokinetic effects and significantly reduced vomiting and also improved other symptoms of diabetic gastroparesis compared with placebo. ClincialTrials.gov number: NCT01571297.
authors.affiliation: Beth Israel Deaconess Medical Center, Boston, Massachusetts. Electronic address: alembo@bidmc.harvard.edu.
authors.forename: Anthony
authors.initials: A
authors.lastname: Lembo
authors.affiliation: Mayo Clinic, College of Medicine, Rochester, Minnesota.
authors.forename: Michael
authors.initials: M
authors.lastname: Camilleri
authors.affiliation: Department of Internal Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas.
authors.forename: Richard
authors.initials: R
authors.lastname: McCallum
authors.affiliation: APF Research, LLC, Miami, Florida.
authors.forename: Ramon
authors.initials: R
authors.lastname: Sastre
authors.affiliation: International Research Associates, LLC, Miami, Florida.
authors.forename: Cristian
authors.initials: C
authors.lastname: Breton
authors.affiliation: Rhythm, Boston, Massachusetts.
authors.forename: Sharon
authors.initials: S
authors.lastname: Spence
authors.affiliation: Rhythm, Boston, Massachusetts.
authors.forename: Jeffery
authors.initials: J
authors.lastname: White
authors.affiliation: Rhythm, Boston, Massachusetts.
authors.forename: Michelle
authors.initials: M
authors.lastname: Currie
authors.affiliation: Rhythm, Boston, Massachusetts.
authors.forename: Keith
authors.initials: K
authors.lastname: Gottesdiener
authors.affiliation: Rhythm, Boston, Massachusetts.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Stoner
mesh_terms: D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D004311:Double-Blind Method; D005260:Female; D005746:Gastric Emptying / Q000187:drug effects*; D018589:Gastroparesis / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009842:Oligopeptides / Q000008:administration & dosage*; D016896:Treatment Outcome; D014839:Vomiting / Q000188:drug therapy* / Q000209:etiology
chemical_list: D009842:Oligopeptides; C000593860:relamorelin
keywords: Dose Comparison; Gastrointestinal Motility; Phase 2 Trial; RM-131