TY - JOUR
T1 - Effects of tegaserod and erythromycin in upper gut dysmotility
T2 - A comparative study
AU - Nasr, Issam
AU - Rao, Satish S.C.
AU - Attaluri, Ashok
AU - Hashmi, Syed M.A.
AU - Summers, Robert
N1 - Funding Information:
Dr Rao is supported by Grant R01DK57100-03, National Institutes of Health. The authors would like to thank Bridget Zimmerman, PhD for her advice with statistical analysis, and Ms Kim Klein for secretarial assistance.
PY - 2009
Y1 - 2009
N2 - Objectives Tegaserod may enhance upper gut transit, but, its prokinetic effects on antral/small bowel motility and how this compares with erythromycin is unknown. We prospectively assessed and compared the effects of tegaserod and erythromycin on upper gut motility. Methods In an open label, non-crossover study, 22 patients (M/F=4/18; mean age=37 years) with symptoms of upper gut dysmotility underwent 24-hour ambulatory antroduodenojejunal manometry with a six-sensor solid state probe. The effects of 12 mg oral tegaserod were compared with 125 mg intravenous erythromycin by quantifying pressure wave activity and assessing motor patterns. Results Motor activity increased (p<0.05) in antrum, duodenum and jejunum with both drugs when compared to baseline period. The motor response with tegaserod was higher (p<0.05) in jejunum and occurred during the second or third hours, whereas with erythromycin, it was higher (p<0.05) in antrum and occurred within 30 minutes. After tegaserod, a 'fed-response' like pattern was seen whereas after erythromycin, large amplitude (>100 mmHg) antral contractions at 3 cycles per minute were seen. Following tegaserod and erythromycin, phase III MMCs occurred in 12 (55%) and 8 (36%) patients respectively (p>0.05). Conclusions Both drugs increase upper gut motility and induce MMC's, but exert a differential response. Tegaserod produces a more sustained prokinetic effect in the duodenum/ jejunum, whereas erythromycin predominantly increases antral motor activity.
AB - Objectives Tegaserod may enhance upper gut transit, but, its prokinetic effects on antral/small bowel motility and how this compares with erythromycin is unknown. We prospectively assessed and compared the effects of tegaserod and erythromycin on upper gut motility. Methods In an open label, non-crossover study, 22 patients (M/F=4/18; mean age=37 years) with symptoms of upper gut dysmotility underwent 24-hour ambulatory antroduodenojejunal manometry with a six-sensor solid state probe. The effects of 12 mg oral tegaserod were compared with 125 mg intravenous erythromycin by quantifying pressure wave activity and assessing motor patterns. Results Motor activity increased (p<0.05) in antrum, duodenum and jejunum with both drugs when compared to baseline period. The motor response with tegaserod was higher (p<0.05) in jejunum and occurred during the second or third hours, whereas with erythromycin, it was higher (p<0.05) in antrum and occurred within 30 minutes. After tegaserod, a 'fed-response' like pattern was seen whereas after erythromycin, large amplitude (>100 mmHg) antral contractions at 3 cycles per minute were seen. Following tegaserod and erythromycin, phase III MMCs occurred in 12 (55%) and 8 (36%) patients respectively (p>0.05). Conclusions Both drugs increase upper gut motility and induce MMC's, but exert a differential response. Tegaserod produces a more sustained prokinetic effect in the duodenum/ jejunum, whereas erythromycin predominantly increases antral motor activity.
KW - Dysmotility
KW - Erythromycin
KW - Small bowel manometry
KW - Tegaserod
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U2 - 10.1007/s12664-009-0048-6
DO - 10.1007/s12664-009-0048-6
M3 - Article
C2 - 19937173
AN - SCOPUS:77954673204
SN - 0254-8860
VL - 28
SP - 136
EP - 142
JO - Indian Journal of Gastroenterology
JF - Indian Journal of Gastroenterology
IS - 4
ER -