Comparison of PPIs and H2-receptor antagonists plus prokinetics for dysmotility-like dyspepsia

• Published in: World journal of gastroenterology : WJG 2012-04, Vol.18 (13), p.1517-1524
• Main Authors: Sakaguchi, Masahiro, Takao, Miyuki, Ohyama, Yasuo, Oka, Hiroshi, Yamashita, Hiroshi, Fukuchi, Takumi, Ashida, Kiyoshi, Murotani, Masahiro, Murotani, Masuyo, Majima, Kazuo, Morikawa, Hiroshi, Hashimoto, Takashi, Kiyota, Keisuke, Esaki, Hirohiko, Amemoto, Kanji, Isowa, Gouhei, Takao, Fumiyuki
• Format: Article
• Language: English
• Subjects: 2-Pyridinylmethylsulfinylbenzimidazoles - therapeutic use; Adult; Aged; Anti-Ulcer Agents - therapeutic use; Benzamides - therapeutic use; Brief; Dyspepsia - drug therapy; Dyspepsia - physiopathology; Esophageal Motility Disorders - drug therapy; Esophageal Motility Disorders - physiopathology; Famotidine - therapeutic use; Female; Gastrointestinal Agents - therapeutic use; H2受体拮抗剂; Helicobacter Infections - drug therapy; Helicobacter pylori; Histamine H2 Antagonists - therapeutic use; Humans; Male; Middle Aged; Morpholines - therapeutic use; Patient Satisfaction; Proton Pump Inhibitors - therapeutic use; Rabeprazole; 不良症状; 功能障碍; 指数和; 消化不良; 生产者; 运动; 配合治疗
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v18.i13.1517

AIM： To compare efficacy of proton pump inhibitors （PPIs） with H2-receptor antagonists （H2RA$） plus pro- kinetics （Proks） for dysmotility-like symptoms in func- tional dyspepsia （FD）. METHODS： Subjects were randomized to receive openlabel treatment with either rabeprazole 10 mg od （n = 57） or famotidine 10 mg bid plus mosapride 5 mg tid （n = 57） for 4 wk. The primary efficacy endpoint was change （%） from baseline in total dysmotility-like dyspepsia symptom score. The secondary efficacy endpoint was patient satisfaction with treatment. RESULTS： The improvement in dysmotility-like dyspep- sia symptom score on day 28 was significantly greater in the rabeprazole group （22.5% ± 29.2% of baseline） than the famotidine ＋ mosapride group （53.2%±58.6% of baseline, P 〈 0.0001）. The superior benefit of rabeprazole treatment after 28 d was consistent regardless of Helicobacter pylori status. Significantly more subjects in the rabeprazole group were satisfied or very satisfied with treatment on day 28 than in the famotidine ＋ mosapride group （87.7% vs 59.6%, P = 0.0012）. Rabeprazole therapy was the only significant predictor of treatment response （P 〈 0.0001）, defined as a total symptom score improvement ≥ 50%. CONCLUSION： PPI monotherapy improves dysmotil- ity-like symptoms significantly better than H2RAs plus Proks, and should be the treatment of first choice for Japanese FD.