Study of Promethazine for Treatment of Diabetic Gastroparesis

NCT ID: NCT02130622

Last Updated: 2018-08-07

Study Results

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Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE2

Total Enrollment

3 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-07-31

Study Completion Date

2015-05-14

Brief Summary

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Adult diabetic patients (ages 18-65) with gastric emptying scintigraphy-confirmed delayed gastric emptying will be recruited to participate in the study. Using double-blinded methodology, study participants will be randomly assigned to one of two treatment arms: promethazine 12.5 mg three times daily for 28 days or placebo three times daily for 28 days. The primary outcome will be the change in gastroparesis symptom severity, as measured by the Gastroparesis Cardinal Symptom Index (GCSI) at four weeks compared to baseline. Participants will be seen for a clinic evaluation at weeks 0, 2 and 4, during which symptom scores, adverse events and treatment compliance will be assessed. It is hypothesized promethazine treatment will be superior to placebo in improving symptoms of gastroparesis.

Detailed Description

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Conditions

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Diabetic Gastroparesis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Promethazine

Promethazine 12.5 mg P.O. t.i.d. for 4 weeks

Group Type EXPERIMENTAL

Promethazine

Intervention Type DRUG

Sugar Pill

Placebo P.O. t.i.d. for 4 weeks

Group Type PLACEBO_COMPARATOR

Sugar pill

Intervention Type DRUG

Interventions

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Promethazine

Intervention Type DRUG

Sugar pill

Intervention Type DRUG

Other Intervention Names

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Phenergan Placebo

Eligibility Criteria

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Inclusion Criteria

* adult patients 18-65 years of age
* clinical diagnosis of diabetic gastroparesis.
* EGD without evidence of gastric outlet obstruction within the past five years
* gastric emptying scintigraphy test demonstrating \>10% solid food retention at 4 hours within the past three years.

Exclusion Criteria

* the inability or unwillingness to provide informed consent
* currently pregnant or breast feeding
* prior placement of a gastric stimulator
* pyloric botulinum toxin injection within the past 12 months
* prior gastric surgery
* history of a connective tissue disorder
* use of narcotic medication within the past four weeks
* hemoglobin A1C \>12 mg/dL within the past 3 months
* current or recent (within past 4 weeks) use of promethazine, metoclopramide or domperidone
* hypersensitivity or prior adverse reaction to promethazine
* concomitant use of phenothiazines (i.e. prochlorperazine, chlorpromazine) or other agents likely to increase extrapyramidal reactions
* concomitant use of tiotropium or ipratropium
* narrow angle glaucoma
* urinary retention
* Parkinson's disease
* significant psychiatric disease
* history of seizure.
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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American College of Gastroenterology

OTHER

Sponsor Role collaborator

Dartmouth-Hitchcock Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Brian E. Lacy, MD

Role: PRINCIPAL_INVESTIGATOR

Dartmouth-Hitchcock Medical Center

Locations

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Dartmouth-Hitchcock Medical Center

Lebanon, New Hampshire, United States

Site Status

Countries

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United States

References

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Cherian D, Parkman HP. Nausea and vomiting in diabetic and idiopathic gastroparesis. Neurogastroenterol Motil. 2012 Mar;24(3):217-22, e103. doi: 10.1111/j.1365-2982.2011.01828.x. Epub 2011 Nov 27.

Reference Type BACKGROUND
PMID: 22118574 (View on PubMed)

Janssen P, Harris MS, Jones M, Masaoka T, Farre R, Tornblom H, Van Oudenhove L, Simren M, Tack J. The relation between symptom improvement and gastric emptying in the treatment of diabetic and idiopathic gastroparesis. Am J Gastroenterol. 2013 Sep;108(9):1382-91. doi: 10.1038/ajg.2013.118.

Reference Type BACKGROUND
PMID: 24005344 (View on PubMed)

Ricci DA, Saltzman MB, Meyer C, Callachan C, McCallum RW. Effect of metoclopramide in diabetic gastroparesis. J Clin Gastroenterol. 1985 Feb;7(1):25-32. doi: 10.1097/00004836-198502000-00003.

Reference Type BACKGROUND
PMID: 3884697 (View on PubMed)

McCallum RW, Ricci DA, Rakatansky H, Behar J, Rhodes JB, Salen G, Deren J, Ippoliti A, Olsen HW, Falchuk K, et al. A multicenter placebo-controlled clinical trial of oral metoclopramide in diabetic gastroparesis. Diabetes Care. 1983 Sep-Oct;6(5):463-7. doi: 10.2337/diacare.6.5.463.

Reference Type BACKGROUND
PMID: 6400707 (View on PubMed)

Perkel MS, Moore C, Hersh T, Davidson ED. Metoclopramide therapy in patients with delayed gastric emptying: a randomized, double-blind study. Dig Dis Sci. 1979 Sep;24(9):662-6. doi: 10.1007/BF01314461.

Reference Type BACKGROUND
PMID: 385260 (View on PubMed)

Snape WJ Jr, Battle WM, Schwartz SS, Braunstein SN, Goldstein HA, Alavi A. Metoclopramide to treat gastroparesis due to diabetes mellitus: a double-blind, controlled trial. Ann Intern Med. 1982 Apr;96(4):444-6. doi: 10.7326/0003-4819-96-4-444.

Reference Type BACKGROUND
PMID: 7065559 (View on PubMed)

Patterson D, Abell T, Rothstein R, Koch K, Barnett J. A double-blind multicenter comparison of domperidone and metoclopramide in the treatment of diabetic patients with symptoms of gastroparesis. Am J Gastroenterol. 1999 May;94(5):1230-4. doi: 10.1111/j.1572-0241.1999.00456.x.

Reference Type BACKGROUND
PMID: 10235199 (View on PubMed)

Erbas T, Varoglu E, Erbas B, Tastekin G, Akalin S. Comparison of metoclopramide and erythromycin in the treatment of diabetic gastroparesis. Diabetes Care. 1993 Nov;16(11):1511-4. doi: 10.2337/diacare.16.11.1511.

Reference Type BACKGROUND
PMID: 8299441 (View on PubMed)

McHugh S, Lico S, Diamant NE. Cisapride vs metoclopramide. An acute study in diabetic gastroparesis. Dig Dis Sci. 1992 Jul;37(7):997-1001. doi: 10.1007/BF01300277.

Reference Type BACKGROUND
PMID: 1618070 (View on PubMed)

Feldman M, Smith HJ. Effect of cisapride on gastric emptying of indigestible solids in patients with gastroparesis diabeticorum. A comparison with metoclopramide and placebo. Gastroenterology. 1987 Jan;92(1):171-4. doi: 10.1016/0016-5085(87)90854-7.

Reference Type BACKGROUND
PMID: 3781184 (View on PubMed)

Ehrenpreis ED, Deepak P, Sifuentes H, Devi R, Du H, Leikin JB. The metoclopramide black box warning for tardive dyskinesia: effect on clinical practice, adverse event reporting, and prescription drug lawsuits. Am J Gastroenterol. 2013 Jun;108(6):866-72. doi: 10.1038/ajg.2012.300.

Reference Type BACKGROUND
PMID: 23735907 (View on PubMed)

Tan PC, Khine PP, Vallikkannu N, Omar SZ. Promethazine compared with metoclopramide for hyperemesis gravidarum: a randomized controlled trial. Obstet Gynecol. 2010 May;115(5):975-981. doi: 10.1097/AOG.0b013e3181d99290.

Reference Type BACKGROUND
PMID: 20410771 (View on PubMed)

Braude D, Crandall C. Ondansetron versus promethazine to treat acute undifferentiated nausea in the emergency department: a randomized, double-blind, noninferiority trial. Acad Emerg Med. 2008 Mar;15(3):209-15. doi: 10.1111/j.1553-2712.2008.00060.x.

Reference Type BACKGROUND
PMID: 18304050 (View on PubMed)

Revicki DA, Rentz AM, Dubois D, Kahrilas P, Stanghellini V, Talley NJ, Tack J. Development and validation of a patient-assessed gastroparesis symptom severity measure: the Gastroparesis Cardinal Symptom Index. Aliment Pharmacol Ther. 2003 Jul 1;18(1):141-50. doi: 10.1046/j.1365-2036.2003.01612.x.

Reference Type BACKGROUND
PMID: 12848636 (View on PubMed)

Revicki DA, Camilleri M, Kuo B, Szarka LA, McCormack J, Parkman HP. Evaluating symptom outcomes in gastroparesis clinical trials: validity and responsiveness of the Gastroparesis Cardinal Symptom Index-Daily Diary (GCSI-DD). Neurogastroenterol Motil. 2012 May;24(5):456-63, e215-6. doi: 10.1111/j.1365-2982.2012.01879.x. Epub 2012 Jan 27.

Reference Type BACKGROUND
PMID: 22284754 (View on PubMed)

Reilly MC, Bracco A, Ricci JF, Santoro J, Stevens T. The validity and accuracy of the Work Productivity and Activity Impairment questionnaire--irritable bowel syndrome version (WPAI:IBS). Aliment Pharmacol Ther. 2004 Aug 15;20(4):459-67. doi: 10.1111/j.1365-2036.2004.02091.x.

Reference Type BACKGROUND
PMID: 15298641 (View on PubMed)

Wahlqvist P, Carlsson J, Stalhammar NO, Wiklund I. Validity of a Work Productivity and Activity Impairment questionnaire for patients with symptoms of gastro-esophageal reflux disease (WPAI-GERD)--results from a cross-sectional study. Value Health. 2002 Mar-Apr;5(2):106-13. doi: 10.1046/j.1524-4733.2002.52101.x.

Reference Type BACKGROUND
PMID: 11918826 (View on PubMed)

Other Identifiers

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D14076

Identifier Type: -

Identifier Source: org_study_id

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