INFLUENCE OF DIFFERENT PROKINETIC DRUGS O N GASTROINTESTINAL TRANSIT TIMES IN PATIENTS WITH PROGRESSIVE-SYSTEMIC SCLEROSIS

The intestine is involved in about half of the cases with progressive- systemic sclerosis, Intestinal transit disturbances which are caused b y neuropathy of the enteric nerve system occur frequently. However, up -to-date only few studies which determined the effect of prokinetic dr ugs exist. Patients with intestinal involvement caused by progressive- systemic sclerosis were treated with the prokinetic drugs cisapride (2 0 mg, TID; n = 9), erythromycin (250 mg: TID; n = 7) and octreotide (5 0 mu g s. c., at night time; n = 5) over a period of four weeks. At st udy entry and after each treatment period the transit times through th e stomach, small and large intestine were evaluated by use of the met al-detector test. Gastric emptying was only accelerated by erythromyci n (42 +/- 3 min vs. 54 +/- 6 min; p = 0.0422), whereas treatment with cisapride and octreotide did not result in significant changes (48 +/- 4 min: p = 0.3743 and 44 +/- 4 min: p = 0.1975: resp.). Small intesti nal transit times were not altered significantly by cisapride (108 +/- 15 min vs. 108 +/- 9 min: p = 0.2733), erythromycin (92 +/- 8 min; p = 0.0707) or octreotide (106 +/- 12 min: p = 0.8927). Furthermore colo nic transit was not fastened by none of the prokinetic agents (study e ntry: 68 +/- 12 h; cisapride: 88 +/- 12 h; p = 0.0569; erythromycin 77 +/- 14 h; p = 0.7349: octreotide 107 +/- 14 h; p = 0.8927). Four pati ents were withdrawn from the study because of diarrhea. Prokinetic dru gs do not seem to have a major impact on intestinal transit times in p atients with progressive-systemic sclerosis. The use of these drugs is limited because of frequent side effects.