Domperidone for Refractory Gastrointestinal Disorders - Full Text View

Sponsor:	Arnold, George, M.D.
Information provided by:	Arnold, George, M.D.
ClinicalTrials.gov Identifier:	NCT00777439

Purpose

The purpose of this study is to prescribe oral domperidone for subjects with gastrointestinal disorders who have failed or suffered adverse effects from standard medical treatment.

Condition	Intervention
Gastroparesis	Drug: Domperidone

Study Type:	Interventional
Study Design:	Treatment, Non-Randomized, Open Label, Single Group Assignment, Efficacy Study
Official Title:	An Investigational New Drug Program for the Use of Domperidone in the Treatment of Refractory Gastroesophageal Reflux Disease and Other Gastrointestinal Motility Disorders

Resource links provided by NLM:

MedlinePlus related topics: Digestive Diseases GERD

Drug Information available for: Dopamine Domperidone Domperidone maleate

U.S. FDA Resources

Further study details as provided by Arnold, George, M.D.:

Primary Outcome Measures:

Improvement of symptoms for patients with gastrointestinal disorders who have failed or suffered adverse effects from standard medical treatment. [ Time Frame: Domperidone will be prescrided as long as patients benefit from taking it. ] [ Designated as safety issue: No ]

Estimated Enrollment:	30
Study Start Date:	October 2008
Estimated Study Completion Date:	January 2010
Estimated Primary Completion Date:	January 2010 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Domperidone All eligible subjects will receive domperidone in an open label, single group assignment.	Drug: Domperidone 10 mg of oral domperidone will be administered 4 times daily. This dose may be increased to 20 mg 4 times daily or 30 mg 4 times daily, depending on how the subject responds to the drug.

Detailed Description:

Domperidone is a dopamine-2 receptor antagonist. It acts as a prokinetic agent through its effects on the chemoreceptor trigger zone and the motor function of the stomach and small intestines. It does not cause any adverse neurological symptoms and has an excellent safety profile for long-term oral administration in recommended doses.

In the United States, domperidone is not approved by the Food and Drug Administration (FDA) and cannot be obtained by routine prescriptions or covered by health care insurance plans. It is also illegal to write a prescription for the subject to obtain the drug outside the U.S. Domperidone can be administered legally by obtaining a FDA Investigational New Drug (IND) application with Institutional Review Board (IRB) approval.

This study will follow FDA and IRB regulations and provide domperidone to subjects with gastrointestinal disorders who have failed from standard therapy.

Eligibility

Ages Eligible for Study:	18 Years and older
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Male or female
Age 18 or older
Symptoms or manifestations secondary to GERD (e.g., persistent esophagitis, heartburn, upper airway signs or symptoms or respiratory symptoms), gastrointestinal motility disorders such as nausea, vomiting, severe dyspepsia or severe chronic constipation that are refractory to standard therapy.
Subjects must have a comprehensive evaluation to eliminate other causes of their symptoms.
Subject has signed informed consent for the administration of domperidone. The informed consent informs the subject of potential adverse events including:
- increased prolactin levels
- extrapyramidal side effects
- breast changes
- cardiac arrhythmias including QT prolongation
- there is a potential for increased risk of adverse events with the drugs listed in the addendum

Exclusion Criteria:

History of or current cardiac disease, including ischemic or valvular heart disease, other structural heart defects, cardiomyopathy or congestive heart failure.
History of or current arrhythmias including ventricular tachycardia, ventricular fibrillation and Torsade des Pointes. Subjects with minor forms of ectopy (PACs) are not necessarily excluded.
Clinically significant bradycardia, sinus node dysfunction, or heart block. Prolonged QT syndrome (QTc greater than 450 milliseconds for males, greater 470 milliseconds for females) or family history prolonged QT syndrome.
Presence of a prolactinoma (prolactin-releasing pituitary tumor).
Conditions that result in electrolyte disorders, such as severe dehydration, vomiting, malnutrition, eating disorders, renal diseases, or the use of potassium-wasting diuretics or insulin in acute settings. (Note that the presence of vomiting, that may accompany gastroparesis or pseudo- obstruction does not by itself exclude the subject - only if accompanied by electrolyte disturbance must the subject be excluded.)
Pregnant or breast feeding female.
Known allergy to domperidone or any components of the domperidone formulation.
Significantly significant electrolyte disorders.
Gastrointestinal hemorrhage or obstruction.

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00777439

Contacts

Contact: Mary R. Beaves, BSN	412-623-1309	beavesmr@upmc.edu
Contact: George L. Arnold, MD	412-621-2334	arnoldgl@upmc.edu

Locations

United States, Pennsylvania
Associates in Gastroenterology	Recruiting
Pittsburgh, Pennsylvania, United States, 15232
Contact: Mary R. Beaves, BSN 412-623-1309 beavesmr@upmc.edu
Principal Investigator: George L. Arnold, MD

Sponsors and Collaborators

Arnold, George, M.D.

Investigators

Principal Investigator:

George L. Arnold, MD

George L. Arnold, MD, FACP

More Information

Publications:

Abell TL, Bernstein RK, Cutts T, Farrugia G, Forster J, Hasler WL, McCallum RW, Olden KW, Parkman HP, Parrish CR, Pasricha PJ, Prather CM, Soffer EE, Twillman R, Vinik AI. Treatment of gastroparesis: a multidisciplinary clinical review. Neurogastroenterol Motil. 2006 Apr;18(4):263-83. Review.

Barone JA. Domperidone: a peripherally acting dopamine2-receptor antagonist. Ann Pharmacother. 1999 Apr;33(4):429-40. Review.

Ahmad N, Keith-Ferris J, Gooden E, Abell T. Making a case for domperidone in the treatment of gastrointestinal motility disorders. Curr Opin Pharmacol. 2006 Dec;6(6):571-6. Epub 2006 Sep 25. Review.

Reddymasu SC, Soykan I, McCallum RW. Domperidone: review of pharmacology and clinical applications in gastroenterology. Am J Gastroenterol. 2007 Sep;102(9):2036-45. Epub 2007 May 3. Review.

Soykan I, Sarosiek I, McCallum RW. The effect of chronic oral domperidone therapy on gastrointestinal symptoms, gastric emptying, and quality of life in patients with gastroparesis. Am J Gastroenterol. 1997 Jun;92(6):976-80.

Responsible Party:	George L. Arnold, MD, FACP ( George L. Arnold, MD, FACP )
Study ID Numbers:	GLA102024, FDA IND#102024
Study First Received:	October 21, 2008
Last Updated:	October 21, 2008
ClinicalTrials.gov Identifier:	NCT00777439 History of Changes
Health Authority:	United States: Food and Drug Administration

Keywords provided by Arnold, George, M.D.:

Dopamine
Domperidone
Gastroparesis
Gastrointestinal Diseases
Neurologic Manifestations

Stomach Diseases
Digestive System Diseases
Esophagitis
Esophageal Disorders
Paralysis

Additional relevant MeSH terms:

Neurotransmitter Agents
Molecular Mechanisms of Pharmacological Action
Gastrointestinal Diseases
Physiological Effects of Drugs
Gastrointestinal Agents
Antiemetics
Dopamine Antagonists
Gastroesophageal Reflux
Pharmacologic Actions
Esophageal Motility Disorders
Deglutition Disorders
Paralysis

Signs and Symptoms
Digestive System Diseases
Stomach Diseases
Domperidone
Autonomic Agents
Therapeutic Uses
Neurologic Manifestations
Dopamine Agents
Peripheral Nervous System Agents
Esophageal Diseases
Central Nervous System Agents
Gastroparesis

ClinicalTrials.gov processed this record on February 04, 2010