Effect of Mosapride Citrate on Gastric Emptying in Interferon-Induced Gastroparesis

• Published in: Digestive diseases and sciences 2012-06, Vol.57 (6), p.1510-1516
• Main Authors: Kawamura, Etsushi, Enomoto, Masaru, Kotani, Kohei, Hagihara, Atsushi, Fujii, Hideki, Kobayashi, Sawako, Iwai, Shuji, Morikawa, Hiroyasu, Kawabe, Joji, Tominaga, Kazunari, Tamori, Akihiro, Shiomi, Susumu, Kawada, Norifumi
• Format: Article
• Language: English
• Subjects: Adult; Aged; Benzamides - therapeutic use; Biochemistry; Biological response modifiers; Boceprevir; Care and treatment; Dose-Response Relationship, Drug; Drug Administration Schedule; Evaluation; Female; Follow-Up Studies; Gastric Emptying - drug effects; Gastroenterology; Gastroparesis - chemically induced; Gastroparesis - physiopathology; Health aspects; Hepatitis C; Hepatitis C, Chronic - diagnosis; Hepatitis C, Chronic - drug therapy; Hepatology; Humans; Interferon; Interferon alpha; Interferon-alpha - adverse effects; Interferon-alpha - therapeutic use; Male; Medicine; Medicine & Public Health; Middle Aged; Morpholines - therapeutic use; Oncology; Original Article; Polyethylene Glycols - adverse effects; Polyethylene Glycols - therapeutic use; Prospective Studies; Recombinant Proteins - adverse effects; Recombinant Proteins - therapeutic use; Reference Values; Ribavirin; Ribavirin - adverse effects; Ribavirin - therapeutic use; Severity of Illness Index; Statistics, Nonparametric; Transplant Surgery; Treatment Outcome
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1007/s10620-012-2085-8

Background and Objectives Gastroparesis, a gastrointestinal autonomic neuropathy, is a common adverse reaction in chronic hepatitis C (CHC) patients receiving interferon therapy. Current therapeutic options are limited. We evaluated the efficacy of mosapride for IFN-induced gastroparesis. Methods Twenty-four consecutive CHC patients were randomly assigned to either the control group, which received pegylated interferon α-2b at 1.5 μg/kg/week and ribavirin at 600–1,000 mg/day, depending on body weight (PegIFN/RBV), or the mosapride group, which received PegIFN/RBV plus mosapride at 15 mg/person/day. The solid-phase gastric emptying half-times (T1/2) of the total, proximal, and distal stomach (scintigraphy) and digestive symptoms (questionnaire) were measured within one week before and four weeks after initiation of the assigned therapy. The test meal comprised a 200-g pancake containing Tc-99m diethylenetriamine pentaacetic acid. Results In the control group, after PegIFN/RBV initiation, a significant increase was observed in the total T1/2 (before: 84.0 ± 22.1 min versus after: 100.8 ± 28.9 min, P  = 0.03), the distal T1/2 (before: 95.3 ± 32.2 min versus after: 115.3 ± 41.4 min, P  = 0.03), and digestive symptom score (before: 3.2 ± 1.4 versus after: 8.1 ± 4.8, P  = 0.02); proximal T1/2 change was not significant. In the mosapride group, no significant delays were observed in the total, proximal, and distal T1/2 values; the change in symptom scores was not significant. Conclusions Mosapride improved total and distal gastric motility in IFN-induced gastroparesis, and consequently relieved symptoms.