Effect of intravenous administration of EM523L on gastric emptying and plasma glucose levels after a meal in patients with diabetic gastroparesis: a pilot study.

EM523L, a newly developed erythromycin derivative, has a powerful motilin-like biologic effect and no antibacterial activity. In this pilot study, EM523L was administered to six patients with diabetic gastroparesis, and its effects on gastric emptying function and the change in plasma glucose levels after eating were examined. Gastric emptying was evaluated by the simultaneous measurement of solid and liquid food intake using 99mTc-Sn-colloid and acetaminophen, respectively. Eggs labeled with isotope and milk with added acetaminophen were used as the test meals. The change in plasma glucose level after ingestion of the test meal was also examined. A total of 2 mg of EM523L dissolved in 100 mL of physiologic saline was administered by intravenous infusion over a period of 15 minutes after ingestion of the test meal. The retention rates of the gastric isotope decreased following the administration of EM523L at 20 to 120 minutes after ingestion of the test meal. Plasma acetaminophen concentrations following EM523L administration increased at 20 and 30 minutes. The plasma glucose levels showed an increase at 30 to 60 minutes after eating--the result of improved gastric emptying function. From these results, we concluded that intravenous administration of EM523L in patients with severe diabetic gastroparesis promotes gastric emptying of a solid and liquid meal and, as a result, plasma glucose levels increase after eating.