Diabetes Care, Vol 21, Issue 10 1699-1706, Copyright © 1998 by American Diabetes Association
Effect of domperidone on the health-related quality of life of patients with symptoms of diabetic gastroparesis
CE Farup, NK Leidy, M Murray, GR Williams, L Helbers and EM Quigley
Janssen Research Foundation, Titusville, New Jersey 08560, USA.
OBJECTIVE: To describe the health-related quality of life (HRQOL) of
patients with insulin-treated diabetes and symptoms of diabetic
gastroparesis and to assess the impact of domperidone on HRQOL in these
patients. RESEARCH DESIGN AND METHODS: This two-phase multicenter study was
part of a safety and efficacy investigation. Phase I involved 4-week
single-blind treatment with domperidone 20 mg q.i.d. (n=269). Patients
demonstrating significant symptomatic improvement (n=208) continued to
phase 11, a 4-week, double-blind, parallel-group study with patients
receiving placebo (n=103) or domperidone (n=105). Patients completed the
Medical Outcomes Study Short-Form-36 Health Survey at selection and at the
end of each phase. Physical component summary (PCS) and mental component
summary (MCS) scores served as primary parameters, and the eight subscales
were secondary parameters. RESULTS: HRQOL scores of subjects enrolled in
the trial were significantly lower than norms from the general population
and people with diabetes (P < 0.001). Subjects experiencing symptomatic
improvement after 4 weeks of single-blind treatment demonstrated
significant improvement in all HRQOL parameters (P < 0.001); PCS, MCS,
and six subscale scores of nonresponders did not change. Between-group
change score differences were significant for PCS, MCS, and seven subscales
(P < 0.05 to P < 0.001). During phase II, the domperidone group
maintained their HRQOL; the placebo group showed a significant decline in
PCS and four subscales (P < 0.05). The between-group difference in the
PCS score change was statistically significant (-1.77 vs. 0.65, P=0.05).
CONCLUSIONS: Results suggest that patients with symptoms of diabetic
gastroparesis experience notable HRQOL impairment and that symptomatic
relief with domperidone is accompanied by improvements in HRQOL that can be
sustained over 4 weeks of treatment.