Table 2.
Medical treatment for gastrointestinal complications in ATTRv
| Underlying pathology | Symptoms | Available treatments |
|---|---|---|
| Gastroparesis | Early satiety, nausea and vomiting | D2 receptor antagonists |
| Domperidonea | ||
| Metoclopramide | ||
| Levosulpiridea | ||
| Motilin receptor agonists | ||
| Erythromycin | ||
| 5-HT4 agonists | ||
| Prucalopride | ||
| Ghrelin agonist | ||
| Relamorelinb | ||
| Small bowel bacterial contamination | Constipation/diarrhoea, diarrhoea | Antibioticsc |
| Rifaximin | ||
| Metronidazole | ||
| Amoxicillin/clavulanic acid | ||
| Doxycycline | ||
| Probioticsd | ||
| Slow transit | Constipation | Osmotic active preparations |
| Polyethylene glycol | ||
| Picosulphatea | ||
| 5-HT4 agonists | ||
| Linaclotide | ||
| Lubiprostonea | ||
| Prucalopride | ||
| Bile acid malabsorption | Diarrhoea | Bile acid sequestrants |
| Cholestyramine (preferably in conjunction with a reduced-fat diet) | ||
| Rapid GI transit | Diarrhoea | Opioid receptor agonists |
| Loperamide | ||
| Somatostatin analogues | ||
| Octreotide |
aNot available in all countries
bUnder consideration for approval by the European Medicines Agency
cAccording to local practice; the most effective antibiotic for this indication is not settled
dSubstantial variation in types of probiotics among different countries; most preparations contain strains of Lactobacillus