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Therapy of GERD and FD overlap with symptoms after usual-dose PPI: Acotiamide plus usual-dose PPI vs. double-dose PPI

Journal of Gastroenterology and Hepatology Sep 07, 2017

Takeuchi T, et al. – The clinicians aimed to compare the efficacy of acotiamide in combination with a standard dose of rabeprazole for gastroesophageal reflux disease (GERD) and functional dyspepsia (FD) with that of a double dose of rabeprazole. In patients with overlap between GERD and FD experiencing heartburn and epigastric fullness symptoms after standard–dose proton pump inhibitor (PPI) for ≥8 weeks, acotiamide 300 mg/day in combination with rabeprazole 10 mg/day or rabeprazole 20 mg/day relieved symptoms, and the efficacies did not differ between the two treatments. For persistent symptoms, the combination therapy could be an alternative option in these patients.

Methods
  • The clinicians randomized patients with overlap between GERD and FD experiencing heartburn and epigastric fullness symptoms after standard-dose proton pump inhibitor (PPI) for ≥8 weeks into 2 groups, and received either acotiamide 300 mg/day + rabeprazole 10 mg/day or rabeprazole 20 mg/day for 4 weeks.
  • They evaluated efficacy by reductions in symptom scores using the Izumo scale questionnaire and modified F-scale questionnaire.

Results
  • With no significant difference between the two groups, 3 upper gastrointestinal symptoms (heartburn, epigastralgia, and epigastric fullness) were reduced by ≥50% in 40.8% and 46.9% of patients in the combination and PPI double-dose groups, respectively, as the primary endpoint.
  • For the modified F-scale questionnaire, essentially similar results were obtained.
  • There were no serious adverse events.
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