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CCK‐1 receptor blockade for treatment of biliary colic: a pilot study
Author(s) -
Malesci A.,
Pezzilli R.,
D'Amato M.,
Rovati L.
Publication year - 2003
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.2003.01688.x
Subject(s) - medicine , cholecystokinin , anticholinergic , blockade , analgesic , cholecystokinin receptor , biliary colic , adverse effect , antagonist , visual analogue scale , anesthesia , receptor antagonist , visceral pain , gastroenterology , gallbladder , endocrinology , receptor , nociception
Summary Background: Loxiglumide is a potent and selective cholecystokinin‐1 (CCK‐1) receptor antagonist able to inhibit gall‐bladder contraction. Aim: To assess the effect of CCK‐1 receptor blockade on the pain of patients with biliary colic. Patients and methods: Fourteen patients with biliary colic but no suspicion for acute cholecystitis, were randomly and blindly assigned to loxiglumide (50 mg i.v.) or hyoscine‐N‐butyl bromide (20 mg i.v.) treatment. Pain intensity was monitored by a Visual Analogue Scale. Patients with less than 80% response at 30 min, were retreated with a second injection of the same compound. Results: Reduction in pain score (mean ± S.E.M.) was faster and significantly greater in patients treated with loxiglumide ( n = 7) than in controls ( n = 7): 88 ± 7% vs. 47 ± 12% after 20 min, P < 0.05; 92 ± 6% vs. 49 ± 13%, after 30 min, P < 0.05. Only one of seven patients treated with loxiglumide needed a second injection at 30 min (vs. six of seven controls, P < 0.05). No adverse effect was observed after either treatment. Conclusions: Loxiglumide is highly effective in obtaining pain relief in patients with biliary colic. The analgesic effect of CCK‐1 receptor blockade is superior to that of a conventional anticholinergic treatment.