Evolving prokinetic therapy: New targets and therapeutic opportunities in gastrointestinal motility disorders

Figure 2 Timeline of prokinetic drug development. Chronological overview of key milestones in the development of prokinetic agents, highlighting regulatory approvals, market withdrawals, re-approvals, and the emergence of novel therapeutic targets. The timeline traces progression from early agents such as metoclopramide and cisapride to newer therapies including 5-hydroxytryptamine type 4 agonists, sodium-hydrogen exchanger 3 inhibitors, motilin and ghrelin receptor agonists, illustrating evolving efficacy and safety considerations in gastrointestinal motility disorders. CIC: Chronic idiopathic constipation; FDA: Food and Drug Administration; GERD: Gastroesophageal reflux disease; IBS-C: Irritable bowel syndrome with constipation; NHE3: Sodium-hydrogen exchanger 3.