Double-blind comparison of cisapride and cimetidine in treatment of reflux esophagitis

Galmiche, Jean–Paul; Fraitag, B; Filoche, B; Evreux, M; Vitaux, Jean; Zeitoun, P; Fournet, Jacques; Soulé, J C

doi:10.1007/bf01540415

Cited by 75 publications

(23 citation statements)

References 13 publications

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“…can provide effective symptomatic relief and healing of esophagitis, with results comparable to cimetidine 400 mg q.i.d. or ranitidine 150 mg b.i.d., and superior to placebo (72)(73)(74). Combined therapy with cimetidine and either metoclopramide (10 mg q.i.d.)…”

Section: The Available Promotility Agents (Cisapride and Metoclopramimentioning

confidence: 99%

Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease

DeVault¹

1999

The American Journal of Gastroenterology

143

178

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PREAMBLEGuidelines for the diagnosis and treatment of gastroesophageal reflux disease (GERD) were published by the American College of Gastroenterology in 1995 (1). These and other guidelines undergo periodic review. Significant advances have been made in the area of GERD over the past several years, leading us to review and revise our previous guidelines statements. These advances have included an increase in our comfort with the chronic use of proton pump inhibitors and an increased acceptance of laparoscopic antireflux surgery, among other factors. These and the original guidelines are intended to apply to all physicians who address GERD and are intended to indicate the preferable, but not only acceptable, approach. Physicians must always choose the course best suited to the individual patient and the variables that exist at the moment of the decision. These guidelines are intended to apply to adult patients with the symptoms, tissue damage, or both that result from the reflux of gastric contents into the esophagus. For the purpose of these guidelines GERD is defined as chronic symptoms or mucosal damage produced by the abnormal reflux of gastric contents into the esophagus.Both these and the original guidelines were developed under the auspices of the American College of Gastroenterology and its Practice Parameters Committee, and approved by the Board of Trustees. The world literature was reviewed extensively for the original guidelines and was once again reviewed using the National Library of Medicine database. All appropriate studies were reviewed and any additional studies found in the reference list of these papers were obtained and reviewed. Evidence was evaluated along a hierarchy, with randomized controlled trials given the greatest weight. Abstracts presented at national and international meetings were only used when unique data from ongoing trials were presented. When scientific data were lacking, recommendations were based on expert consensus. During preparation, the guidelines were reviewed

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Section: The Available Promotility Agents (Cisapride and Metoclopramimentioning

confidence: 99%

Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease

DeVault¹

1999

The American Journal of Gastroenterology

143

178

View full text Add to dashboard Cite

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“…and ranitidine 150 mg b.i.d. in reducing reflux symptoms and healing esophagitis (table 1) [29][30][31].…”

Section: Promotility Therapymentioning

confidence: 99%

A Prokinetic Approach to Treatment of Gastroesophageal Reflux Disease

Achem¹,

Robinson

1998

Dig Dis

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Currently available medications for gastroesophageal reflux disease (GERD) vary in mechanisms of action from neutralization or suppression of gastric acid to improving underlying upper gastrointestinal dysmotility. This article reviews the clinical efficacy of pharmacological agents used to treat GERD and provides a rationale for considering a primary prokinetic approach to antireflux treatment which will be applicable to many patients. Treatment trials in acute GERD have demonstrated unexpectedly prolonged maintenance of high esophageal pH with tablet and liquid antacid formulations. However, there are no well-designed placebo-controlled trials of antacids for esophageal mucosal healing. H₂ receptor antagonists (H2RAs) at conventional doses relieve reflux symptoms in at least 50% of reported series of GERD patients, and they can also provide endoscopic healing in 27–45% of the cases. Therapy with more potent acid-suppressive agents such as proton pump inhibitors (PPIs) may lead to improved symptomatic relief and to superior healing compared with H2RA therapy, especially in those patients with more advanced erosive esophagitis. Promotility agents, particularly cisapride, offer symptom relief and healing rates which are quite similar to standard H2RA treatment. GERD tends to be a chronic and relapsing condition. Cisapride has been shown to be quite effective in maintaining remission in GERD patients, including endoscopic remission in the lesser degrees of esophagitis. This may be accomplished with relatively low and cost-effective dosing in many individuals. For the small proportion of patients who manifest severe grades of esophagitis, PPI therapy is associated with lower relapse rates than either H2RA or prokinetic treatment. Overall, a strong case can be made for the empirical selection of promotility therapy for the large numbers of GERD patients who do not have documented severe erosive disease.

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“…cisapride) to enhance LOS tone and oesophageal clearance, these agents are only moderately ineffective in GERD, and require prolonged use before any bene®t is seen. 63,64 Anti-re¯ux therapy has focused largely on suppressing gastric acid secretion with H 2 -receptor antagonists and proton pump inhibitors. In general, the H 2 -receptor antagonists are less effective in the management of GERD than in peptic ulcer disease.…”

Section: Short-term Management Options For Gerdmentioning

confidence: 99%

current practice and future perspectives in the management of gastro‐oesophageal reflux disease

Lambert

1997

Aliment Pharmacol Ther

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Gastro‐oesophageal reflux disease (GERD) is primarily due to incompetence of the lower oesophageal sphincter (LOS) and crural diaphragm, with transient LOS relaxation frequently accounting for daytime reflux. In the absence of drugs that adequately correct the motility defects of GERD, treatment is directed towards decreasing gastric acidity. Oesophageal healing is related to control of 24‐h intragastric acidity, the degree of acid suppression and duration of treatment. H2‐receptor antagonists are generally less effective in GERD than in peptic ulcer disease. While providing symptomatic relief in non‐erosive GERD, they are often ineffective in healing erosive oesophagitis. Proton pump inhibitors provide more rapid and complete healing and symptom resolution. They are superior to H2‐receptor antagonists in the long‐term management of erosive oesophagitis and in reducing recurrence of oesophageal stricture following mechanical dilatation. In Barrett's oesophagus, high‐dose proton pump inhibitors in combination with laser/photodynamic ablation therapy can produce metaplastic regression, although this does not preclude future emergence of adenocarcinoma. Surgical morbidity and mortality rates in GERD generally remain higher than those associated with long‐term pharmacotherapy. However, direct comparisons between laparascopic anti‐reflux surgery and proton pump inhibitor maintenance therapy remain to be performed. Although there is no evidence that H. pylori infection worsens the severity of oesophagitis or that H. pylori is carcinogenic in the metaplastic oesophageal mucosa, it has been suggested that H. pylori‐positive patients requiring long‐term proton pump inhibitor therapy receive bacterial eradication therapy to reduce the risk of developing atrophic gastritis.

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Double-blind comparison of cisapride and cimetidine in treatment of reflux esophagitis

Cited by 75 publications

References 13 publications

Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease

Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease

A Prokinetic Approach to Treatment of Gastroesophageal Reflux Disease

current practice and future perspectives in the management of gastro‐oesophageal reflux disease

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