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CLINICAL TRIAL article

Front. Pharmacol.
Sec. Gastrointestinal and Hepatic Pharmacology
Volume 15 - 2024 | doi: 10.3389/fphar.2024.1413246

Comparison of Enteral Prucalopride versus Intravenous Metoclopramide for Feeding Intolerance in Patients with Critical Illness: A Randomized Double-blinded Study

Provisionally accepted
Eman M. Elmokadem Eman M. Elmokadem 1Dina K. Abou El Fadl Dina K. Abou El Fadl 1Nermin Eissa Nermin Eissa 2Najla A. Alnassar Najla A. Alnassar 3Ahmed M. Bassiouny Ahmed M. Bassiouny 4Nouran O. El Said Nouran O. El Said 1*
  • 1 Pharmacy Practice & Clinical Pharmacy, Faculty of Pharmacy, Future University in Egypt, New Cairo, Egypt
  • 2 Department of Biomedical Sciences, College of Health Sciences, Abu Dhabi University, Abu Dhabi, United Arab Emirates
  • 3 Human Nutrition and Dietetics, College of Health Sciences, Abu Dhabi University, Abu Dhabi, United Arab Emirates
  • 4 Faculty of Medicine, Ain Shams University, Cairo, Beni Suef, Egypt

The final, formatted version of the article will be published soon.

    Background: Feeding intolerance is commonly experienced during enteral feeding, necessitating cessation. Metoclopramide may be given to assist gastric emptying, but patients experience adverse effects and gradual loss of efficacy. Prucalopride, a safer prokinetic, may play a role in gastric emptying. Therefore, the current study aimed to assess its effectiveness and safety in feeding intolerance developed in critically ill patients.In this prospective randomized double-blinded study, patients with feeding intolerance were randomized to receive 2 mg prucalopride enterally once daily or 10 mg metoclopramide intravenously every 6-8 hours for seven days. Patients were monitored for treatment failure, successful feeding, gastric residual volume (GRV), and the development of medication-related adverse effects.Results: A total of 70 patients (35 in the metoclopramide group and 35 in the prucalopride group) completed the study. The average daily GRV in the prucalopride group was significantly lower compared to the metoclopramide group (p=<0.001) on day 7. Additionally, the percentage change in GRV from day 1 to day 7 showed a greater significant change in the prucalopride arm versus the metoclopramide arm (p=<0.001). The treatment groups were comparable in terms of ICU length of stay (p=0.094). Moreover, there was a significantly higher successful caloric intake in the prucalopride group compared to the metoclopramide group on day 7(p=0.039).Prucalopride administration in enterally fed patients with feeding intolerance may reduce GRV and improve feeding success rates compared to metoclopramide treatment. The use of prucalopride was found to be tolerable and safe in critically ill patients.ClinicalTrials.gov Identifier: NCT05496179

    Keywords: prokinetic, Feeding intolerance, gastric residual volume, Prucalopride, Critical Illness

    Received: 06 Apr 2024; Accepted: 28 Oct 2024.

    Copyright: © 2024 Elmokadem, Abou El Fadl, Eissa, Alnassar, Bassiouny and El Said. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Nouran O. El Said, Pharmacy Practice & Clinical Pharmacy, Faculty of Pharmacy, Future University in Egypt, New Cairo, Egypt

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.