Comparative effects of levosulpiride and cisapride on gastric emptying and symptoms in patients with functional dyspepsia and gastroparesis (original) (raw)
Related papers
Alimentary Pharmacology & Therapeutics, 1998
Background:The electrogastrogram (EGG), which records gastric myoelectrical activity, is abnormal in one‐third of adult patients with non‐ulcer dyspepsia (NUD).Aim:To observe the effects of cisapride on EGG in adults with NUD.Methods:Twenty‐seven NUD patients who had undergone a pre‐ and post‐prandial EGG were entered into an open study. All patients completed a dyspepsia symptom questionnaire and were then treated with cisapride 10 mg t.d.s. The dyspepsia questionnaire was repeated in all those completing 4 weeks of treatment. Those with an initial abnormal EGG (< 70% of slow wave activity at 2–4 cycles per minute) had a repeat EGG at the end of the study.Results:Treatment with cisapride was associated with a significant improvement in the post‐prandial EGG (P = 0.007). After 4 weeks of treatment, 7 of 13 abnormal EGGs normalized. Symptom scores improved significantly in the 13 patients with an abnormal EGG who completed treatment (P < 0.0003), but not in NUD patients with a ...
Association Between Symptoms, Quality of Life, and Gastric Emptying in Dyspeptic Patients
Journal of Neurogastroenterology and Motility
Background/Aims Association between symptoms, quality of life and gastric emptying in dyspepsia is inconsistent in the literature. The aim of our study is to investigate if gastric emptying is associated with specific symptoms and quality of life in dyspeptic patients. Methods We reviewed retrospectively gastric emptying measured by 13 C-labelled octanoate breath testing for more than 6 hours in 198 consecutive patients with dyspepsia complaints. Gastrointestinal symptoms were assessed using a 5-points Likert scale and by a symptomatic composite score, whereas quality of life was measured by the GIQLI. Results In our cohort, 90 patients (45%) had a delayed gastric emptying (half emptying time above 166 minutes when assessed over 6-8 hours). There was no difference in symptoms or quality of life between patients with or without delayed gastric emptying. However, patients with severely delayed gastric emptying (half emptying time above 200 minutes) had increased postprandial fullness (P = 0.012), abdominal pain (P = 0.026), bloating (P = 0.044), early satiety (P = 0.018), symptomatic composite score (P = 0.005), and a lower quality of life (P = 0.018). This association was no longer observed if the calculation of gastric emptying was limited to the first 4-hour samples. Conclusions There is no association between symptoms, quality of life and gastric emptying in an overall dyspeptic population. However, there is an association between symptoms, quality of life of delayed gastric emptying in the subgroup of patients with severely delayed gastric emptying. An 8-hour measurement of gastric emptying should be recommended.
Efficacy of cisapride and domperidone in functional (nonulcer) dyspepsia: a meta-analysis
The American journal of gastroenterology, 2001
The efficacy of prokinetic agents in functional (nonulcer) dyspepsia has been questioned based on recent trial results. We performed a meta-analysis to determine the efficacy of cisapride and domperidone in functional dyspepsia. Computer and manual searching was used to identify placebo-controlled studies that included >20 patients. The statistical analysis focused on: global assessment by the investigator, epigastric pain, early satiety, abdominal distension and nausea (all rated on four-point scales). Results are reported as odds ratios (OR) in favor of treatment. Regression analysis was performed to evaluate possible effect modifiers. The relationship between improvement in gastric emptying and symptoms was also evaluated. For cisapride, 17 studies met the inclusion criteria, but varying numbers of studies had to be used for the different outcome measures. For all outcome measures, there was a statiscally significant benefit in favor of cisapride: global assessment of improvem...
Effectiveness and safety of levosulpiride in the treatment of dysmotility-like functional dyspepsia
Therapeutics and Clinical Risk Management, 2007
The objective of this study was to assess the effectiveness and safety of levosulpiride in patients with dysmotility-like functional dyspepsia including nonerosive reflux esophagitis in conditions of daily practice. The study was conducted as a prospective, open-label, multicenter design in 342 patients with dysmotility-like functional dyspepsia (n=279) and nonerosive reflux disease (n=63), who received levosulpiride 25 mg 3 times daily orally for 4 weeks. Individual symptoms (pain/discomfort, fullness, bloating, early satiety, pyrosis, regurgitation, and nausea/vomiting) and a global symptom score were assessed at 15, 30, and 60 days after starting treatment. Adverse events also were recorded. There were 151 men and 191 women (mean age 38.8 years) who referred dyspeptic symptoms for a mean of 10.2 (10.7) months. A total of 66.4% patients were treated with 75 mg/day levosulpiride and 33.6% with 50 mg/day. At the 15-day visit, a decrease greater than 50% in the global symptom score was observed. The frequency and intensity of individual symptoms showed a statistically significant decrease (p<0.001) at all visits compared with baseline. At the 30-day visit, all symptoms had almost disappeared, a trend that was maintained until the last visit. Treatment with levosulpiride was well tolerated and only 40 adverse events were recorded (galactorrhea 26.7%, somnolence 17.8%, fatigue 11.1%, headache 11.5%) and no patient had to abandon the study due to side effects. In conclusion, levosulpiride is an effective and safe drug in the treatment of dysmotility-like functional dyspepsia and non-erosive reflux disease.
Journal of the Medical Association of Thailand Chotmaihet Thangphaet, 2005
Objective: This study was undertaken to determine whether H. pylori infection has an effect on the improvement of dyspeptic symptoms in response to a prokinetic agent, cisapride, in patients with non-ulcer dyspepsia (NUD). Material and Method: 35 NUD patients (16 M, 19 F) who had no underlying medical condition and negative upper endoscopy were included in the present study. Each patient received a 2-wk treatment of cisapride (Prepulsid ® , 10 mg, tid ac). H. pylori infection was determined using a rapid urease test (CLO test ® ). Gastric emptying (GE) scintigraphy and dyspeptic symptom scores were evaluated before and at the end of the treatment. GE was evaluated in 22 healthy volunteers as normal controls. Results: Half time (T1/2) GE of NUD patients was 90.9 + 28 min which was significantly longer than controls (77.6 + 14 min; p < 0.05) and was shortened to 73.6 + 22 min (p < 0.0001) at the end of the treatment. Cisapride significantly improved total dyspeptic symptom scores [7 (2-18) to 3 (0-11), p < 0.0001]. The symptom score improvement was not affected by H. pylori infection [H. pylori positive: 6 (2-18) to 2.5 (0-9), p < 0.0001; H. pylori negative: 9 (4-16) to 3 (0-11), p < 0.0001] or GE status to 3 (1-5), p < 0.05; non delayed to 2 (0-11); p < 0.0001]. Conclusions: Cisapride improves dyspeptic symptoms regardless of H. pylori and GE status. These results suggest that gastric emptying and H. pylori infection are not essential to determine prior to prescribing a prokinetic agent, cisapride, in patients with NUD.