Ghrelin Agonist Decreased Gastric Emptying Time in Women With Anorexia

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Median gastric emptying time was significantly decreased in participants receiving relamorelin compared with placebo.
Median gastric emptying time was significantly decreased in participants receiving relamorelin compared with placebo.

According to the results of a study published in the Journal of Clinical Psychiatry, women with anorexia nervosa receiving relamorelin, a ghrelin agonist, tended to gain weight and had shorter gastric emptying time compared with placebo.

In this randomized controlled trial, 22 outpatient women with anorexia nervosa based on Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, criteria were randomly assigned to receive either daily relamorelin 100 μg subcutaneously or placebo for 4 weeks (ClinicalTrials.gov identifier: NCT01642550). Changes in weight and gastric emptying time based on a gastric emptying breath test were compared between groups.

At baseline, participants had comparable mean age, weight, body mass index, and median gastric emptying time.

After 4 weeks of treatment, participants receiving relamorelin had a nonsignificant increase in mean weight compared with the placebo group (0.86±0.40 kg vs 0.04±0.28 kg; P =.07). Furthermore, median gastric emptying time was significantly decreased in participants receiving relamorelin compared with placebo (58.0 vs 85.0 minutes; P =.03).

Similar changes in mean hunger score (P =.26) and median self-reported gastrointestinal symptoms (P =.65) were reported between groups. Overall, relamorelin was well tolerated. An increase in hunger led to discontinuation of the trial in 2 participants in the relamorelin group. The proportion of patients experiencing dizziness was significantly higher in the relamorelin group compared with placebo (62.5% vs 8.3%; P =.02).

"Treatment with a ghrelin agonist in women with anorexia nervosa significantly decreases gastric emptying time, leads to a trend in weight gain after only 4 weeks, and is well-tolerated," the researchers concluded.

"As there are no currently approved medical therapies for the treatment of this chronic disease characterized by significant morbidity and mortality, further study is necessary to determine the long-term efficacy and safety of a ghrelin agonist as a potential therapeutic option for individuals with anorexia nervosa."

Reference

Fazeli PK, Lawson EA, Faje AT, et al. Treatment with a ghrelin agonist in outpatient women with anorexia nervosa: a randomized clinical trial. J Clin Psychiatry. 2018;79(1):17m11585.

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