The use of domperidone (DOM), for gastroparesis (GP) remains controversial and limited. We aimed to present outcomes of DOM therapy for treatment of patients participating in the multicenter NIDDK Gastroparesis Clinical Research Consortium (GPCRC) Registries (GpR).
The GpCRC cohort consisted of GP (75%) and GP-like symptoms patients but with normal gastric emptying (25%). The DOM group initiated therapy during the 96 weeks of enrollment in GpR1 and 2. Patients who had previously taken or were on DOM therapy at enrollment were excluded from this analysis. The control group did not use domperidone (non-DOM group) before or after enrollment. The following outcome measures were identified: change from baseline in Gastroparesis Cardinal Symptom Index (GCSI) total score, with 3 subscales, plus GERD and PAGI-QOL scores.
Overall, of 748 patients, 181 (24%) were in the DOM, while 567 were in non-DOM group. 63% of participants had idiopathic GP. At baseline DOM compared to non-DOM patients were significantly younger, had lower BMI, non-Hispanic ethnicity, a higher annual household income, lower narcotic utilization, lower supplemental and complimentary medication use, more likely to have delayed GET, as well as worse nausea and fullness scores. Compared to non-DOM, DOM patients experienced moderate, but significantly more improvement in GP outcome measures: GCSI total score (p=0.003), nausea (p=0.003), and fullness subscales (p=0.005), upper abdominal pain score (p=0.04), GERD score (p=0.05) and PAGI-QOL (p=0.05).
Utilizing the method of pragmatic modeling to evaluate long-term treatment of GP in a large GpCRC database, domperidone treatment resulted in moderately but significantly improved GP.