Effect of mosapride combined with esomeprazole improves esophageal peristaltic function in patients with gastroesophageal reflux disease: a study using high resolution manometry.

Abstract

BACKGROUND:

Whether addition of prokinetics to proton pump inhibitors improves esophageal peristalsis and symptoms in patients with gastroesophageal reflux disease (GERD) remains unknown.

AIM:

We evaluated the effect of mosapride, a 5-HT4 agonist, and PPI cotherapy in patients with GERD on esophageal motility using high-resolution manometry (HRM).

METHOD:

This study was designed as a double-blind, randomized, placebo-controlled trial. Patients with GERD were allocated to a group either taking 40 mg esomeprazole plus 30 mg mosapride or taking esomeprazole plus placebo. Symptom assessment and the HRM study were conducted before drug treatment and after 4 weeks.

RESULTS:

Of 50 patients enrolled, 24 in the mosapride group (49 years old, 15 males) and 19 in the placebo group (43 years old, nine males) completed the study. Approximately 79 % of the patients had normal peristaltic function. Treatment response was not different between the two groups (79 vs. 68 %). Mosapride cotherapy tended to yield better response in patients with dyspepsia than those without dyspepsia (92 vs. 67 %). Lower esophageal sphincter pressure didn't change in both groups. Intrabolus pressure decreased in the mosapride group (3.4 ± 3.5 mmHg to 1.4 ± 4.1 mmHg, P < 0.05). Distal esophageal amplitude increased in the mosapride group and not in the placebo group (81 ± 34 to 89 ± 29 mmHg vs. 82 ± 32 to 83 ± 31 mmHg).

CONCLUSION:

Adding mosapride on esomeprazole improved esophageal contractability and lowered intrabolus pressure in patients with GERD. Mosapride and esomeprazole cotherapy tended to yield better response in patients with concomitant dyspepsia.

• Authors: Yu Kyung Cho, Myung-Gyu Choi, Eun Young Park, Chul Hyun Lim, Jin Su Kim, Jae Myung Park, In Seok Lee, Sang Woo Kim, Kyu Yong Choi
• Journal: Digestive diseases and sciences (Dig Dis Sci) Vol. 58 Issue 4 Pg. 1035-41 (Apr 2013) ISSN: 1573-2568 [Electronic] United States
• PMID: 23053900 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Ulcer Agents
• Benzamides
• Morpholines
• Proton Pump Inhibitors
• Serotonin Receptor Agonists
• mosapride
• Esomeprazole

Topics

• Adult
• Aged
• Anti-Ulcer Agents (therapeutic use)
• Benzamides (therapeutic use)
• Double-Blind Method
• Drug Therapy, Combination
• Esomeprazole (therapeutic use)
• Esophagus (drug effects)
• Female
• Gastroesophageal Reflux (drug therapy)
• Humans
• Male
• Manometry
• Middle Aged
• Morpholines (therapeutic use)
• Peristalsis (drug effects)
• Proton Pump Inhibitors (therapeutic use)
• Serotonin Receptor Agonists (therapeutic use)