Ghrelin receptor agonist (TZP-101) accelerates gastric emptying in adults with diabetes and symptomatic gastroparesis

Aliment Pharmacol Ther. 2009 Jun 1;29(11):1179-87. doi: 10.1111/j.1365-2036.2009.03986.x. Epub 2009 Feb 27.

Abstract

Background: TZP-101 is a synthetic, selective ghrelin agonist in development for gastroparesis.

Aim: To assess safety and effects of TZP-101 in diabetes patients with symptomatic gastroparesis.

Methods: Adults with type 1 or type 2 diabetes mellitus received placebo and TZP-101 (80, 160, 320 or 600 microg/kg) infusions in a cross-over manner following a radiolabelled meal. Blood glucose levels were stabilized using a hyperinsulinemic-euglycemic clamp. Primary endpoints were gastric half emptying and latency times. Secondary measures included assessment of gastroparesis symptoms and endocrine responses.

Results: Ten patients with type 1 (n = 7) or 2 (n = 3) diabetes, moderate-to-severe gastroparesis symptoms and > or =29% retention 4 h after a radiolabelled solid meal were enrolled. TZP-101 produced significant reductions in solid meal half-emptying (20%, P = 0.043) and latency (34%, P = 0.037) times vs. placebo. Reductions in overall postmeal symptom intensity (24%) and postprandial fullness (37%) following TZP-101 infusion were not statistically significant. Most adverse events were mild and self-limiting and there were no identifiable differences in numbers or types of adverse events between TZP-101 and placebo.

Conclusions: This proof-of-concept study demonstrates that the ghrelin agonist TZP-101 is well-tolerated in diabetes patients with moderate-to-severe chronic gastroparesis and shows statistically significant improvements in gastric emptying.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Blood Glucose
  • Cross-Over Studies
  • Diabetes Complications / complications
  • Diabetes Complications / drug therapy*
  • Double-Blind Method
  • Female
  • Gastric Emptying / drug effects*
  • Gastroparesis / drug therapy*
  • Gastroparesis / etiology
  • Ghrelin / agonists*
  • Ghrelin / therapeutic use
  • Glucose Clamp Technique
  • Humans
  • Macrocyclic Compounds / therapeutic use*
  • Male
  • Middle Aged
  • Treatment Outcome
  • Young Adult

Substances

  • Blood Glucose
  • Ghrelin
  • Macrocyclic Compounds
  • ulimorelin