Cisapride treatment for preterm infants

Craig, J S; Tubman, T. R. J.; McClure, B G

doi:10.1203/00006450-199809000-00076

Cited by 5 publications

(6 citation statements)

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“…Four placebocontrolled trials in premature infants with feeding intolerance and GORD have been published. [10][11][12][13][14] In 2 of these trials, cisapride was no more effective than placebo in improving feeding tolerance, gastric emptying and bodyweight gain. [10,11] In a third study, milk tolerance and gastric emptying increased, and vomiting decreased significantly with cisapride.…”

Section: Cisapride and Treatment Of Gastrointestinal Diseasementioning

confidence: 95%

“…[10][11][12][13][14] In 2 of these trials, cisapride was no more effective than placebo in improving feeding tolerance, gastric emptying and bodyweight gain. [10,11] In a third study, milk tolerance and gastric emptying increased, and vomiting decreased significantly with cisapride. [12] In a trial in preterm infants by McClure and colleagues, [13] cisapride delayed gastric emptying and tended to prolong whole gastrointestinal transit time.…”

Section: Cisapride and Treatment Of Gastrointestinal Diseasementioning

confidence: 95%

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Efficacy and Tolerability of Cisapride in Children

Vandenplas¹,

Benatar²,

Cools³

et al. 2001

Paediatric Drugs

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As gastro-oesophageal reflux disease (GORD) in infants and children is a motility disorder which differs in pathophysiology and clinical course from GORD in adults, prokinetics should be considered the drug of choice in certain circumstances. Indeed, cisapride may result in improvement of feeding tolerance in premature infants. Cisapride has a better tolerability profile than a 'wait-and-see-if-improvement-comes-spontaneously' policy or the other therapeutic options available. A careful and critical review of published data suggests that cisapride may have a QTc-prolonging effect. However, provided the precautions for cisapride administration are followed, the QTc-prolonging effect remains consistently without clinically relevant adverse effects. Correct dosage and avoidance of concurrent treatment with macrolides and/or azoles are the most relevant tolerability recommendations in children. Although there is a need for a prokinetic with better efficacy, cisapride is currently the prokinetic with the best benefit-to-risk ratio available. Thus, withdrawal of cisapride would result in a significantly increased risk for severe complications in infants and children with GORD or other gastrointestinal motility disorders such as chronic intestinal pseudo-obstruction, gastroparesis and feed intolerance in premature infants.

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Section: Cisapride and Treatment Of Gastrointestinal Diseasementioning

confidence: 95%

Section: Cisapride and Treatment Of Gastrointestinal Diseasementioning

confidence: 95%

Efficacy and Tolerability of Cisapride in Children

Vandenplas¹,

Benatar²,

Cools³

et al. 2001

Paediatric Drugs

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show abstract

“…Because there is a striking contradiction in the frequent use of cisapride in preterm infants and the fact that in most countries the drug label mentions that cisapride is contraindicated in this age group, we will discuss the published data in this patient group in more detail. Four placebo-controlled trials in premature newborns with feeding intolerance and GERD were published (13)(14)(15)(16). In two of them, cisapride scored no better in gastric emptying times, food intolerance, and weight gain than placebo (13,14).…”

Section: Cisapride and Treatment Of Gastroesophageal Reflux Diseasementioning

confidence: 99%

Current Pediatric Indications for Cisapride

Vandenplas

2000

J. pediatr. gastroenterol. nutr.

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“…A study of similar design, based in our unit, was halted by the Medicines Control Agency (MCA) because of the possible risks of prolonged QT intervals 2. It is therefore interesting to note that the publication of Enriquez’s study coincides with an update from the MCA.…”

mentioning

confidence: 99%