Gastroparesis is a syndrome characterized by delayed gastric emptying and accompanying symptoms in the absence of gastric outlet obstruction. Although there are multiple causes of gastroparesis, the majority of cases are idiopathic, associated with diabetes or postsurgical procedures. In a general population community study the age-adjusted prevalence of definite gastroparesis per 100,000 persons was 24.2 for both genders, 9.6 for men and 37.8 for women17. In addition, the cumulative incidence of gastroparesis was reported to be 4.8% in type I diabetes, 1% in type 2 diabetes, and 0.1% in nondiabetic people. However, in tertiary medical centers the prevalence of delayed gastric emptying has been reported to effect as high as 15 to 50% of the diabetic population18. According to the American Diabetes Association (ADA) 30.3 million Americans, or 9.4% of the population, had diabetes in 2015. Thus, the number of patients with gastroparesis could potentially equate to millions. In addition, rates for post-surgical gastroparesis range from 0.4-5%17. Gastroparesis significantly impacts quality of life, is associated with morbidity and mortality and increases direct health-care costs through hospitalizations, emergency room, or doctor visits20. Most patients felt that gastroparesis symptoms that are most important to improve with treatment are stomach pain, nausea and vomiting21. Current treatments are less than satisfactory and this represents a large unmet need that remains to be addressed22. Other drugs used have a number of potential drug interactions and lose effectiveness over time. Therefore, improved therapies are needed for the effective treatment of gastroparesis. In this regard, in rats intravenous CRF was reported to inhibit gastric motor function23 and astressin completely blocked surgery-induced gastric stasis13. Thus, astressins offer an alternative means to treat gastroparesis with long-acting effects1.
1 Erchegyi et. al., (2016) J. Med. Chem., 59, 854-866
13 Martinez et. al., (1999) JPET, 290, 629-634
17 Jung et. al., (2009) Gastroenterol., 136, 1225-1233
18 Adewale and Griffin, (2008) Hospital Physician, 44, 27-35
19 Quigley, (2015) Gastroenterol. Clinics of North America, 44, 69-81
20 Camilleri et. al., (2013) Am. J. Gastroenterol., 108, 18-37
21 Yu et. al., (2017) Dig. Dis. Sci., 62, 879-893
22 Pasricha et. al., (2017) Clin. Gastroenterol. and Hepatol., 15, 1184–1190
23 Raybould et. al., (1990) J. Gastrointestinal Motility, 2, 265-272