Effect of mosapride citrate on gastric emptying in interferon-induced gastroparesis.

Abstract

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.

• Authors: Etsushi Kawamura, Masaru Enomoto, Kohei Kotani, Atsushi Hagihara, Hideki Fujii, Sawako Kobayashi, Shuji Iwai, Hiroyasu Morikawa, Joji Kawabe, Kazunari Tominaga, Akihiro Tamori, Susumu Shiomi, Norifumi Kawada
• Journal: Digestive diseases and sciences (Dig Dis Sci) Vol. 57 Issue 6 Pg. 1510-6 (Jun 2012) ISSN: 1573-2568 [Electronic] United States
• PMID: 22399248 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Benzamides
• Interferon alpha-2
• Interferon-alpha
• Morpholines
• Recombinant Proteins
• Polyethylene Glycols
• Ribavirin
• peginterferon alfa-2b
• mosapride

Topics

• Adult
• Aged
• Benzamides (therapeutic use)
• Dose-Response Relationship, Drug
• Drug Administration Schedule
• Female
• Follow-Up Studies
• Gastric Emptying (drug effects)
• Gastroparesis (chemically induced, physiopathology)
• Hepatitis C, Chronic (diagnosis, drug therapy)
• Humans
• Interferon alpha-2
• Interferon-alpha (adverse effects, therapeutic use)
• Male
• Middle Aged
• Morpholines (therapeutic use)
• Polyethylene Glycols (adverse effects, therapeutic use)
• Prospective Studies
• Recombinant Proteins (adverse effects, therapeutic use)
• Reference Values
• Ribavirin (adverse effects, therapeutic use)
• Severity of Illness Index
• Statistics, Nonparametric
• Treatment Outcome