The effect of camicinal GSK962040, a motilin agonist, on gastric emptying and glucose absorption in feed-intolerant critically ill patients: a randomized, blinded, placebo-controlled, clinical trialReport as inadecuate




The effect of camicinal GSK962040, a motilin agonist, on gastric emptying and glucose absorption in feed-intolerant critically ill patients: a randomized, blinded, placebo-controlled, clinical trial - Download this document for free, or read online. Document in PDF available to download.

Critical Care

, 20:232

First Online: 01 August 2016Received: 29 February 2016Accepted: 20 July 2016

Abstract

BackgroundThe promotility agents currently available to treat gastroparesis and feed intolerance in the critically ill are limited by adverse effects. The aim of this study was to assess the pharmacodynamic effects and pharmacokinetics of single doses of the novel gastric promotility agent motilin agonist camicinal GSK962040 in critically ill feed-intolerant patients.

MethodsA prospective, randomized, double-blind, parallel-group, placebo-controlled, study was performed in mechanically ventilated feed-intolerant patients median age 55 19–84, 73 % male, APACHE II score 18 5–37 with a gastric residual volume ≥200 mL. Gastric emptying and glucose absorption were measured both pre- and post-treatment after intragastric administration of 50 mg n = 15 camicinal and placebo n = 8 using the C-octanoic acid breath test BTt1-2, acetaminophen concentrations, and 3-O-methyl glucose concentrations respectively.

ResultsFollowing 50 mg enteral camicinal, there was a trend to accelerated gastric emptying adjusted geometric means: pre-treatment BTt1-2 117 minutes vs. post- treatment 76 minutes; 95 % confidence intervals CI; 0.39, 1.08 and increased glucose absorption AUC240min pre-treatment: 28.63 mmol.min-L vs. post-treatment: 71.63 mmol.min-L; 95 % CI 1.68, 3.72. When two patients who did not have detectable plasma concentrations of camicinal were excluded from analysis, camicinal accelerated gastric emptying adjusted geometric means: pre-treatment BTt1-2 121 minutes vs. post-treatment 65 minutes 95 % CI 0.32, 0.91 and increased glucose absorption AUC240min pre-treatment: 33.04 mmol.min-L vs. post-treatment: 74.59 mmol.min-L; 95 % CI 1.478, 3.449. In those patients receiving placebo gastric emptying was similar pre- and post-treatment.

ConclusionsWhen absorbed, a single enteral dose of camicinal 50 mg accelerates gastric emptying and increases glucose absorption in feed-intolerant critically ill patients.

Trial registrationThe study protocol was registered with the US NIH clinicaltrials.gov on 23 December 2009 Identifier NCT01039805.

KeywordsCritical illness Enteral nutrition Absorption Gastric emptying Motilin agonist Camicinal A comment to this article is available at http:-dx.doi.org-10.1186-s13054-016-1466-3.

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Author: Marianne J. Chapman - Adam M. Deane - Stephanie L. O’Connor - Nam Q. Nguyen - Robert J. L. Fraser - Duncan B. Richa

Source: https://link.springer.com/







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