Effect of acotiamide on gastric emptying in healthy adult humans

Zai, Hiroaki; Matsueda, Kei; Kusano, Motoyasu; Urita, Yoshihisa; Saito, Yuika; Kato, Hiroki

doi:10.1111/eci.12367

Cited by 16 publications

(24 citation statements)

References 36 publications

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“…Interestingly, no effects were found on basal feeding and basal gastric emptying rate . In line with these results, a single dose of acotiamide did not affect gastric emptying rate after a liquid meal in healthy subjects . The results of the current study further support this suggestion, showing no changes in normal/non‐dysfunctional gastric emptying after a 3‐week treatment with acotiamide.…”

Section: Discussionsupporting

confidence: 89%

Acotiamide affects antral motility, but has no effect on fundic motility, gastric emptying or symptom perception in healthy participants

Masuy

Tack

Verbeke

et al. 2019

Neurogastroenterology Motil

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Background Acotiamide, a prokinetic agent was shown to be efficacious in the treatment of functional dyspepsia (FD). The exact mechanism of action is incompletely elucidated. Methods This randomized, placebo‐controlled, cross‐over study aimed to examine the effect of acotiamide on gastric motility, measured as intragastric pressure, gastric emptying (GE) rate and gastrointestinal (GI) symptom perception in healthy volunteers (HVs). Participants were treated with acotiamide (100 mg tid) and placebo for 3 weeks, separated by a 1‐week washout period. A daily symptom diary was collected during both treatments. At the end of each treatment period, GE rate and gastric motility were assessed with a 13C‐octanoic acid breath test and high‐resolution manometry during nutrient infusion, respectively. GI symptom levels were scored during high‐resolution manometry. Data were analyzed using mixed models. The study was registered as NCT03402984. Key Results Twenty HVs (10 female, 25 ± 4.1 years, 22.58 ± 2.73 kg/m2) participated in the study. There was no difference in GE half time between both treatments (P = 0.92). Acotiamide had no effect on fundic pressures before and after nutrient infusion (P = 0.91). However, postprandial antral pressures remained significantly lower compared to placebo (P = 0.015). There was no significant difference in hunger, satiation and GI symptoms scores assessed during IGP measurement and by the daily diary (P > 0.12 for all). Conclusion Acotiamide is associated with lower antral pressures after nutrient intake, whereas it has no effect on fundic pressures, GE rate and symptom perceptions in HVs. Studies in FD need to elucidate whether lower antral pressures induced by acotiamide underlie postprandial symptom improvement in FD.

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Section: Discussionsupporting

confidence: 89%

Acotiamide affects antral motility, but has no effect on fundic motility, gastric emptying or symptom perception in healthy participants

Masuy

Tack

Verbeke

et al. 2019

Neurogastroenterology Motil

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“…Second, we did not measure gastric accommodation and gastric emptying. Delayed gastric emptying was improved by acotiamide in several studies of animal models and humans; however, normal or non-dysfunctional gastric emptying was unaffected by acotiamide [13,24]. In this study, we recruited normal subjects who did not report typical GERD symptoms; hence, our study could not reveal why reflux events during TLESRs were significantly reduced by acotiamide.…”

Section: Discussionmentioning

confidence: 97%

“…We showed that acotiamide significantly decreased the number of nonacid reflux events, but not acid reflux. Zai et al [24] reported that acotiamide did not affect gastric emptying in healthy subjects. On the other hand, there is no data of acotiamide on gastric accommodation in healthy subjects; we can therefore only speculate that the observed effect of acotiamide on the reduction of nonacid reflux may be through a facilitated gastric accommodation, something that should be researched in future study.…”

Section: Discussionmentioning

confidence: 99%

Novel Prokinetic Acotiamide Reduces Transient Lower Esophageal Sphincter Relaxation in Healthy Subjects

Yamashita

Kanamori²,

Fukuchi³

et al. 2015

Digestion

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Background/Aims: Currently, there is no study evaluating the effect of acotiamide on transient lower esophageal sphincter relaxations (TLESRs). The aim of this study was to evaluate the effect of acotiamide on TLESRs using simultaneous high-resolution manometry (HRM) and impedance-pH monitoring. Methods: Ten healthy subjects were enrolled. On day 1, subjects underwent HRM and impedance-pH recordings as a baseline. Subjects ate a 750-kcal liquid meal; recording was continued for 2 h while the subjects were in a sitting position. After the administration of acotiamide 100 mg three times a day for 1 week, subjects underwent HRM and impedance-pH recording under the same protocol. Results: A total of 208 TLESRs were identified at baseline. Acotiamide decreased the total number of TLESRs from 208 to 143 (p < 0.05). The rate of reflux events during TLESRs after acotiamide administration was similar to that at baseline (57% after acotiamide vs. 58% at baseline). Bolus clearance time was significantly reduced by acotiamide. Conclusions: Acotiamide was believed to have the potential for reducing TLESRs and for enhancing esophageal bolus clearance in healthy volunteers. Future research is needed to determine whether the effects of acotiamide that reduce TLESRs and enhance esophageal motility could improve symptoms in patients with refractory gastroesophageal reflux disease.

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“…32 In another study, acotiamide or a placebo was administered orally to 12 subjects 30 min before ingestion of 400 kcal/400 mL of test meal consisting of 64.4% carbohydrate, 17.6% fat, and 18% protein, labeled with 100 mg of 13 C-sodium acetate. 33 Participants with FD symptoms or H. pylori infection were excluded. They were administered acotiamide 100 mg t.i.d.…”

Section: Advanced Clinical Studies Regarding the Effect Of Acotiamidementioning

confidence: 99%

Emerging treatments in neurogastroenterology: Acotiamade, a novel treatment option for functional dyspepsia

Matsushita

Masaoka

Suzuki

2016

Neurogastroenterology Motil

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The aim of this review is to summarize the present staus of basic and clinical approach to acotiamide for the treatment of functional dyspepsia. The agent inhibits acetylcholinesterase in vitro and enhances muscle motility ex vivo. In phase-II studies, 100 mg three times daily (t.i.d.) was determined to be the optimal dose for the treatment of FD. In phase-III studies, overall treatment efficacy (OTE) was significantly better in the acotiamide group (52.2%) than in the placebo group (34.8%). However, the mechanism of its efficacy needs to be further elucidated. Acotiamide effectively improved FD symptoms, particularly postprandial distress syndrome symptoms, without causing major adverse effects.

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Effect of acotiamide on gastric emptying in healthy adult humans

Cited by 16 publications

References 36 publications

Acotiamide affects antral motility, but has no effect on fundic motility, gastric emptying or symptom perception in healthy participants

Acotiamide affects antral motility, but has no effect on fundic motility, gastric emptying or symptom perception in healthy participants

Novel Prokinetic Acotiamide Reduces Transient Lower Esophageal Sphincter Relaxation in Healthy Subjects

Emerging treatments in neurogastroenterology: Acotiamade, a novel treatment option for functional dyspepsia

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