A Double-Blind, Randomized, Placebo-Controlled Trial of Cisapride in Saudi Arabs with Functional Dyspepsia

Al-Quorain, Abdulaziz; Larbi, E.; Al-Shedoki, F.

doi:10.3109/00365529509089785

Cited by 32 publications

(22 citation statements)

References 12 publications

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“…A dichotomous global dyspepsia outcome was reported in 12 trials (in 11 papers) evaluating 829 patients. 82,[164][165][166][167][168][169][170][171][172][173] The meta-analysis suggested that patients treated with prokinetics were more than twice as likely to have an improvement in dyspepsia symptoms compared with patients receiving placebo (RR reduction 55%; 95% CI, 36 to 78) ( Figure 5). However, there was substantial inconsistency between the trials (test for heterogeneity, Q = 37.7, df = 11, p < 0.0001) and there was evidence of asymmetry in a funnel plot of the trial results ( Figure 6) with larger trials showing smaller treatment benefits.…”

Section: Prokinetic Therapymentioning

confidence: 99%

“…A total of 17 trials of prokinetic therapy versus placebo were eligible for meta-analysis; 82,164-178 cisapride was investigated in 15 trials; 82,164,165,[167][168][169][170][171][172][174][175][176][177][178] two studies evaluated domperidone, 166,173 and there were no eligible trials that assessed metoclopramide. A dichotomous global dyspepsia outcome was reported in 12 trials (in 11 papers) evaluating 829 patients.…”

Section: Prokinetic Therapymentioning

confidence: 99%

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The management of dyspepsia: a systematic review.

Delaney

Moayyedi²,

Deeks³

et al. 2000

Health Technology Assessment

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Section: Prokinetic Therapymentioning

confidence: 99%

Section: Prokinetic Therapymentioning

confidence: 99%

The management of dyspepsia: a systematic review.

Delaney

Moayyedi²,

Deeks³

et al. 2000

Health Technology Assessment

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“…Whereas Hiyama et al [54] found significant FD symptom improvement in a meta-analysis comparing pooled prokinetic agents with placebo (N=1,844; PG0.001), numerous placebo-controlled RCTs evaluating individual prokinetic agents demonstrate absent or modest therapeutic significance [55][56][57][58][59].…”

Section: Prokinetic Agentsmentioning

confidence: 99%

Treatment of Functional Dyspepsia and Gastroparesis

Stein

Everhart

Lacy

2014

Curr Treat Options Gastro

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Functional dyspepsia (FD) and gastroparesis (GP) are the two most prevalent gastric neuromuscular disorders. These disorders are frequently confused, have more similarities than differences, and can be thought of as two ends of a continuous spectrum of gastric neuromuscular disorders (Fig. 1). FD is currently defined by the Rome III criteria; it is now subdivided into a pain-predominant subtype (epigastric pain syndrome) and a meal-associated subtype (post-prandial distress syndrome). GP is defined by symptoms in conjunction with delayed gastric emptying in the absence of mechanical obstruction. Symptoms for both FD and GP are similar and include epigastric pain or discomfort, early satiety, bloating, and post-prandial nausea. Vomiting can occur with either diagnosis; it is typically more common in GP. A patient suspected of having either FD or GP should undergo upper endoscopy. In suspected FD, upper endoscopy is required to exclude an alternative organic cause for the patient's symptoms; however, most (70 %) patients with dyspeptic symptoms will have FD rather than an organic disorder. In suspected GP, upper endoscopy is required to rule out a mechanical obstruction. A 4-hour solid-phase gastric emptying scan is recommended to confirm the diagnosis of GP; its utility is unclear in patients with FD, as it may not change treatment. Once the diagnosis of FD or GP is made, treatment should focus on the predominant symptom. This is especially true in patients with GP, as accelerating gastric emptying with the use of prokinetics may not necessarily translate into an improvement in symptoms. Unfortunately, no medication is currently approved for the treatment of FD and, thus, technically, all treatment options remain off-label, including medications for visceral pain (e.g., tricyclic antidepressants) and nausea. This review focuses on treatment options for FD and GP with an emphasis on new advances in the field over the last several years.

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“…Five studies of cross-over design which were carried out before 1987 were identi ed (12)(13)(14)(15)(16). Eight studies, all carried out in 1987 or later, used a parallel group design (17)(18)(19)(20)(21)(22)(23)(24). Based on 95% con dence intervals (95% CI) of the differences in treatment success, a signi cant superiority of cisapride over placebo was found in nine studies.…”

Section: Cisapridementioning

confidence: 99%

Treatment of Non-Ulcer Dyspepsia: a Meta-Analysis of Placebo-Controlled Prospective Studies

Allescher¹

2001

Scandinavian Journal of Gastroenterology

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M, Hartung J. Treatment of non-ulcer dyspepsia: a meta-analysis of placebo-controlled prospective studies. Scand J Gastroenterol 2001;36:934 -941.Background: Dyspeptic symptoms are commonly reported complaints in clinical practice and are mostly the result of functional disorders. Empirical treatment with histamine H 2 -receptor blockers or gastroprokinetics for 2-4 weeks has frequently been proposed as rst line management of these patients. The clinical trials which support the use of these agents, show a high variation in clinical success rate and bene t of these treatments. Methods: The available clinical trials were evaluated, pooled where appropriate and subjected to a meta-analysis with the principal goal to provide valid treatment recommendations for patients with non-ulcer dyspepsia. In the present meta-analysis 19 studies on gastroprokinetics (cisapride, domperidone) and 10 studies on histamine H 2 -receptor antagonists (cimetidine, ranitidine) were included. Results: Based on these studies, a total of 1540 patients were evaluated for histamine H 2 -receptor antagonists (verum n = 786, placebo n = 754) and 1235 patients for gastroprokinetics (verum n = 616, placebo n = 619). The probability for treatment success compared to placebo was 0.2026 (0.1261; 0.2791) for histamine H 2 -receptor antagonists and 0.4029 (0.3042; 0.5069) for gastroprokinetics. Conclusions: Based on these data both treatments are signi cantly more effective than placebo in the symptomatic treatment of non-ulcer dyspepsia, with gastroprokinetics (cisapride, domperidone) being more effective than histamine H 2 -receptor antagonists (cimetidine, ranitidine). Treatment of Non-Ulcer Dyspepsia 941Scand J Gastroenterol Downloaded from informahealthcare.com by University of Glasgow on 10/12/14For personal use only.

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A Double-Blind, Randomized, Placebo-Controlled Trial of Cisapride in Saudi Arabs with Functional Dyspepsia

Abstract: Cisapride is an effective and well-tolerated treatment for FD in Saudi Arabs. Pharmacogenetic factors are unlikely to play any role in its effects.

Cited by 32 publications

References 12 publications

The management of dyspepsia: a systematic review.

The management of dyspepsia: a systematic review.

Treatment of Functional Dyspepsia and Gastroparesis

Treatment of Non-Ulcer Dyspepsia: a Meta-Analysis of Placebo-Controlled Prospective Studies

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