Prokinetics for functional dyspepsia

Pittayanon, Rapat; Yuan, Yuhong; Bollegala, Natasha; Khanna, Reena; Leontiadis, Grigorios I; Martin, Paul

doi:10.1002/14651858.cd009431.pub3

Cited by 40 publications

(52 citation statements)

References 64 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In a recent meta-analysis evaluating the effect of several prokinetics on FD patients, only itopride improved QoL compared with placebo. 26 However, we found that total scores in NDI-K, as well as scores in each individual area of QoL, increased significantly in both groups by week 4, although they were not compared directly with placebo.…”

Section: Discussionmentioning

confidence: 55%

Efficacy and Safety of DWJ1252 Compared With Gasmotin in the Treatment of Functional Dyspepsia: A Multicenter, Randomized, Double-blind, Active-controlled Study

Park

Lee

et al. 2021

J Neurogastroenterol Motil

View full text Add to dashboard Cite

Background/Aims Prokinetics such as mosapride citrate CR (conventional-release; Gasmotin) are commonly used in functional dyspepsia (FD). This study aims to evaluate the efficacy and safety of once-a-day mosapride citrate SR (DWJ1252), a sustained-release formulation of mosapride citrate, compared with mosapride citrate CR 3 times a day, in patients with FD. Methods In this multicenter, randomized, double-blind, active-controlled, non-inferiority study, 119 patients with FD (by the Rome III criteria, 60 for mosapride citrate SR and 59 for mosapride citrate CR) were randomly allocated to mosapride citrate SR once daily or mosapride citrate CR thrice daily for 4 weeks in 16 medical institutions. Primary end point was the change in gastrointestinal symptom (GIS) score from baseline, assessed by GIS questionnaires on 5-point Likert scale after 4-week treatment. Secondary end points and safety profiles were also analyzed. Results The study included 51 and 49 subjects in the mosapride citrate SR and mosapride citrate CR groups, respectively. GIS scores at week 4 were significantly reduced in both groups (mean ± SD −10.04 ± 4.45 and −10.86 ± 5.53 in the mosapride citrate SR and mosapride citrate CR groups, respectively; P < 0.001), and the GIS changes from baseline did not differ between the 2 groups (difference, 0.82 point; 95% CI, −1.17, 2.81; P = 0.643). Changes in GIS at weeks 2 and 4 and quality of life at week 4, and the improvement rates of global assessments at weeks 2 and 4, did not differ between the groups. Adverse events were similar in the 2 groups, and there were no serious adverse events. Conclusion In patients with FD, mosapride citrate SR once daily is as effective as mosapride citrate CR thrice daily, with a similar safety profile.

show abstract

Section: Discussionmentioning

confidence: 55%

Efficacy and Safety of DWJ1252 Compared With Gasmotin in the Treatment of Functional Dyspepsia: A Multicenter, Randomized, Double-blind, Active-controlled Study

Park

Lee

et al. 2021

J Neurogastroenterol Motil

View full text Add to dashboard Cite

show abstract

“…This may mean that the results of the network are not generalisable to patients with FD consulting in this setting. Finally, unlike previous Cochrane reviews on this topic, 17,18 we did not include RCTs of some prokinetic drugs, such as cisapride or metoclopramide. However, the former has been withdrawn in many countries due to adverse cardiac events, and the latter has had its use restricted to short courses of therapy in Europe due to extra‐pyramidal side effects.…”

Section: Discussionmentioning

confidence: 99%

“…There have been numerous randomised controlled trials (RCTs) of these different drugs vs placebo, and many have demonstrated efficacy in trial‐based systematic reviews and meta‐analyses 16‐19 . However, there have been few head‐to‐head trials of one drug vs another, so the relative efficacy of available treatment options for FD is unclear.…”

Section: Introductionmentioning

confidence: 99%

Systematic review and network meta‐analysis: efficacy of drugs for functional dyspepsia

Ford

Martin

Black

et al. 2020

Aliment Pharmacol Ther

Self Cite

View full text Add to dashboard Cite

Summary Background Functional dyspepsia (FD) is a relapsing and remitting condition affecting between 5% and 10% of people. Efficacious therapies are available, but their relative efficacy is unknown. Aim To perform a systematic review with network meta‐analysis to resolve this uncertainty. Methods We searched the medical literature through July 2020 for randomised controlled trials (RCTs) assessing efficacy of drugs for adults with FD, compared with each other, or placebo. Trials reported a dichotomous assessment of symptom status after completion of therapy. We pooled data using a random effects model. Efficacy was reported as a pooled relative risk (RR) of remaining symptomatic with a 95% confidence interval (CI) to summarise efficacy of each comparison tested. Relative ranking was assessed with surface under the cumulative ranking curve (SUCRA) probabilities. Results We identified 71 eligible RCTs (19 243 participants). Tricyclic antidepressants (TCAs) were ranked second for efficacy (RR of remaining symptomatic = 0.71; 95% CI 0.58‐0.87, SUCRA 0.87), and first when only low risk of bias trials were included. Most RCTs that used TCAs recruited patients who were refractory to other drugs included in the network. Although sulpiride or levosulpiride were ranked first for efficacy (RR = 0.49; 95% CI 0.36‐0.69, SUCRA 0.99), trial quality was low and only 86 patients received active therapy. TCAs were more likely to cause adverse events than placebo. Conclusions TCAs, histamine‐2 receptor antagonists, standard‐ and low‐dose proton pump inhibitors, sulpiride or levosulpiride, itopride and acotiamide were all more efficacious than placebo for FD.

show abstract

“…Interestingly, tegaserod also demonstrated to be effective in attenuating dyspeptic symptoms and significantly reduce abdominal pain in functional dyspepsia (FD) patients [ 38 , 39 ].…”

Section: Introductionmentioning

confidence: 99%

Tegaserod for the Treatment of Irritable Bowel Syndrome

Madia

Messore

Saccoliti

et al. 2020

AIAAMC

View full text Add to dashboard Cite

Background: Tegaserod (Zelnorm®) is a 5-hydroxytryptamine (serotonin) type 4 receptor agonist for the treatment of hypomotility disorders of the lower gastrointestinal tract associated with the irritable bowel syndrome with constipation (IBS-C). Objective: The authors provide the reader with a better understanding on tegaserod mechanism of action, on its pharmacodynamics and pharmacokinetic properties, on safety and tolerability, with a summary of the key published clinical trials conducted in patients with IBS. Its effects on colon inflammation have also been described. Results: Tegaserod was withdrawn in 2007 due to increased risks of cardiovascular adverse effects. The manufacturer denied this, because pre-existing cardiovascular disease or risk factors were attributed to all affected patients. Thus, no causal relationship between tegaserod use and cardiovascular events was clearly shown. A matched case-control study of tegaserod-treated with untreated patients found no association between tegaserod and adverse cardiovascular outcomes. Despite its adverse effects, tegaserod resulted to be effective in treating chronic constipation in adult women aged < 65 years with IBS-C, while the safety and effectiveness of tegaserod in men with IBS-C have not been established. Tegaserod was resubmitted to the Food and Drug Administration in 2018 for use in a low-risk population. Moreover, tegaserod has also been shown to improve symptoms, enhance gastric accommodation and significantly attenuate visceral pain arising from the colon in functional dyspepsia patients. Treatment with tegaserod seems also to exert a protective effect in inflamed colons, reducing the severity of colitis in animal models.

show abstract

Prokinetics for functional dyspepsia

Abstract: Trusted evidence. Informed decisions. Better health.

Cited by 40 publications

References 64 publications

Efficacy and Safety of DWJ1252 Compared With Gasmotin in the Treatment of Functional Dyspepsia: A Multicenter, Randomized, Double-blind, Active-controlled Study

Efficacy and Safety of DWJ1252 Compared With Gasmotin in the Treatment of Functional Dyspepsia: A Multicenter, Randomized, Double-blind, Active-controlled Study

Systematic review and network meta‐analysis: efficacy of drugs for functional dyspepsia

Tegaserod for the Treatment of Irritable Bowel Syndrome

Contact Info

Product

Resources

About