The Unmet Therapeutic Need in Gastroparesis Management
Gastroparesis is a chronic, debilitating neuromuscular disorder of the upper gastrointestinal tract characterized by delayed gastric emptying in the absence of mechanical obstruction. Symptoms such as chronic nausea, vomiting, postprandial fullness, and abdominal pain severely impact quality of life and often lead to significant nutritional deficiencies and hospitalizations. Despite the high disease burden, the therapeutic landscape remains remarkably sparse. For decades, metoclopramide has remained the only FDA-approved medication for gastroparesis, yet its utility is severely limited by a black-box warning regarding tardive dyskinesia and other extrapyramidal side effects due to its ability to cross the blood-brain barrier. Consequently, there is an urgent clinical mandate for the development of peripherally restricted dopamine D2 receptor antagonists that can alleviate symptoms without the neurological risks associated with central dopamine blockade.
