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- W2912593575 abstract "Introduction: Aprepitant, an NK1 receptor antagonist, is approved for the treatment of chemotherapyinduced or postoperative emesis. It is thought to act centrally by blocking binding of substance P to NK1 receptors in the brain stem vomiting center. The APRON trial showed that aprepitant reduces symptoms in patients with gastroparesis and related disorders (Pasricha et al. Am J Gastro 2016;111:S480-1). The mechanisms associated with this benefit are unclear; a single crossover study (Madsen et al. Aliment Pharmacol Ther 2008;27:609-15) did not show a significant effect of aprepitant on gastrointestinal transit. Aim: To compare, in healthy volunteers, the effects of aprepitant vs. placebo on gastric emptying (GE), gastric volumes (GV, fasting and accommodation), satiation and symptoms after a dyspeptogenic meal. Methods: Design: Randomized, double-blind, placebo-controlled, parallel-group study with 12 healthy subjects in each treatment arm. Doses: Aprepitant (125mg on day 1, followed by 80mg on days 2-5) or placebo, one tablet daily, for 5 consecutive days. Measurements were conducted on three days; parameters measured were fasting, postprandial and accommodation GV (by validated radioscintigraphic SPECT method); GE of solids (320kcal, 30% fat meal by scintigraphy), and satiation by nutrient drink test (Ensure® 30mL/min) assessed by volume to comfortable fullness (VTF, mL), maximum tolerated volume (MTV, mL) and symptoms 30 minutes after reaching MTV. The latter test was used to mimic a dyspeptogenic meal, since participants ingested the MTV of Ensure®. Statistical Analysis: Unpaired rank sum test, adjusted for gender and BMI, to compare effects of placebo and aprepitant. Results: Aprepitant increased fasting, postprandial and accommodation GV and tended to increase VTF and MTV by ˜200kcal. However, aprepitant increased aggregate symptom, nausea and pain scores after ingesting the MTV of Ensure® (table). There was no significant effect of aprepitant on GE T1/2 of solids. Conclusion: Aprepitant enhances gastric accommodation and caloric intake, but it increases upper gastrointestinal symptoms in response to a dyspeptogenic meal. These data suggest that the potential beneficial effects of aprepitant may result from effects on GV rather than GE or sensation. Further studies of the pharmacodynamics effects of aprepitant in patients with gastroparesis and dyspepsia are warranted.Table: No Caption available" @default.
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- W2912593575 date "2017-10-01" @default.
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- W2912593575 title "A Randomized, Placebo-Controlled Trial of the Effects of Aprepitant, an NK1 Receptor Antagonist, on Gastric Motor Functions and Satiation in Healthy Volunteers" @default.
- W2912593575 doi "https://doi.org/10.14309/00000434-201710001-01211" @default.
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