Should domperidone be used for the treatment of gastro‐oesophageal reflux in children? Systematic review of randomized controlled trials in children aged 1 month to 11 years old

Pritchard, Deborah; Baber, N.; Stephenson, Terence

doi:10.1111/j.1365-2125.2005.02422.x

Cited by 92 publications

(64 citation statements)

References 12 publications

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“…Desde a suspensão da comercialização da cisaprida, a domperidona passou a ser muito usada, sendo a droga pró-cinética mais usada em nosso meio. Pritchard et al constataram apenas evidências menores da eficácia da domperidona 60 .…”

Section: Situação Clínica Tratamentounclassified

Treatment of gastroesophageal reflux disease

Guimarães¹,

Marguet²,

Camargos³

2006

J Pediatr (Rio J)

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Objective: To review the literature on the treatment of gastroesophageal reflux disease (GERD) with emphasis on pharmacological aspects. To identify particularities of pharmacological treatment of esophageal and extraesophageal manifestations of the disease.Sources: Electronic search of the PubMed/MEDLINE and Cochrane Collaboration databases. Controlled and randomized studies published since 2000 and reviews representing consensus positions and directives published within the last 10 years were identified. Summary of the findings:The drugs currently available for the treatment of GERD do not act in the primary mechanism of the disease, i.e., transitory relaxation of the lower esophageal sphincter. Pharmacological treatment of GERD with symptoms or with esophageal injury is based on the suppression of acid secretion, particularly with proton pump inhibitors. When the hyperreactivity of the lower airways coexists with esophageal GERD symptoms, suppression of acid secretions should be of benefit in managing the respiratory disease in the presence of a causal relationship; however, this is not usual. When esophageal symptoms are not present, esophageal 24-hour pH study should be carried out prior to starting pharmacological treatment for GERD. Improvement of respiratory symptoms may be delayed with relation to esophageal symptoms. It is common for GERD to recur and pharmacological treatment should be repeated or continued indefinitely, depending on clinical presentation of the disease. Conclusions:The strategies that have been proposed for the pharmacological treatment of GERD in children are primarily based on studies of case series or on studies with adults. There have been very few controlled and randomized studies in children. Undertaking a greater number of these studies might reinforce existing aspects or establish new aspects of management.J Pediatr (Rio J). 2006;82(5 Suppl):S133-45: Gastroesophageal reflux, child, drug therapy, esophagitis, respiratory tract diseases, asthma. ResumoObjetivo: Rever a literatura sobre tratamento da doença do refluxo gastroesofágico (DRGE) com ênfase nos aspectos farmacológi-cos. Identificar particularidades do tratamento farmacológico nas manifestações esofágicas e extra-esofágicas da doença.Fontes de dados: Busca eletrônica na base de dados PubMed/ MEDLINE e Cochrane Collaboration. Procurou-se identificar estudos controlados e randomizados publicados a partir de 2000, bem como revisões que representassem consensos e diretrizes publicados nos últimos 10 anos.Síntese dos dados: Nenhuma das drogas atualmente usadas no tratamento da DRGE altera comprovadamente o mecanismo principal da doença, ou seja, os relaxamentos transitórios do esfíncter esofágico inferior. O tratamento farmacológico da DRGE com sintomas ou com lesões esofágicas é baseado na inibição da secreção ácida, em particular pelos inibidores da bomba de prótons (IBP). Nas situações em que a hiper-reatividade das vias aéreas inferiores coexiste com sintomas esofágicos da DRGE, a inibição da secreção ácida deve...

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Section: Situação Clínica Tratamentounclassified

Treatment of gastroesophageal reflux disease

Guimarães¹,

Marguet²,

Camargos³

2006

J Pediatr (Rio J)

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“…Other workers, in fact, have suggested that prokinetics increase gastroesophageal motility and facilitate emptying of the stomach by improving peristalsis and reducing pyloric tone. 15 This beneficial effect, however, was significant after the first drug administration only and was accompanied by an unexpected increase in reflux frequency. Actually there are insufficient safety data to explain these results.…”

Section: Discussionmentioning

confidence: 90%

“…Little, however, is known about its real efficacy and its contraindications, especially in newborns. 15 Aim of the present study was to evaluate the short-term effects of domperidone on GER in symptomatic newborns by means of the simultaneous measurement of impedance and esophageal pH.…”

Section: Introductionmentioning

confidence: 99%

Short-term effect of domperidone on gastroesophageal reflux in newborns assessed by combined intraluminal impedance and pH monitoring

et al. 2008

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Objective: Neonatal gastroesophageal reflux (GER) is primarily due to a transient motility disorder and characterized by a prevalence of weakly acid refluxes. Drug management, where necessary, must set out to reduce the number of refluxes besides correct their acidity. Prokinetics could be of assistance in this respect, though the evidence in favor of their efficacy and safety is still far from sufficient. In this randomized controlled study, the action of domperidone, a prokinetic antidopaminergic drug with little effect on the central nervous system, was evaluated in newborns with symptomatic GER.Study Design: Combined multichannel intraluminal impedance and pH measuring for 24 h was carried out in 13 newborns receiving 0.3 mg per kg domperidone per os at the eighth and the sixteenth hour, and 13 controls. Each newborn was compared to the control nearest in postconceptional age.Result: GER episodes per hour increased significantly compared to the baseline in the domperidone group (4.06±1.16 vs 2.8±1.42; P ¼ 0.001) and were shorter (16.68 ± 4.49 vs 20.18 ± 7.83 s; P ¼ 0.043), whereas there were no differences in the maximu proximal extent reached by the refluxes (3.37 ± 0.45 vs 3.34 ± 0.94 channels; P ¼ 0.894) and their pH (4.72±0.69 vs 4.60±1.17; P ¼ 0.634). Conclusion:This paradoxical increase in the number of GER episodes could be the expression of a domperidone-induced amplification of the motor incoordination of the neonatal gastroesophageal tract. Doubt is thus cast on the efficacy of prokinetics in this age bracket, especially in view of their adverse effects as described in the literature.

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“…They are not widely used for infants due to the side effects of the nervous system, such as metoclopramide, lethargy, irritability, gynecomasty, and tardive dyskinesia, and due to their short duration of effect (33). Domperidone is more frequently used due to its less central effects (34). There is a placebo-controlled trial in the literature indicating the recovery of esophagitis (1).…”

Section: Drugs Preventing Acidmentioning

confidence: 99%

From Newborn to Teenage: Gastroesophageal Reflux

Urgancı¹,

Usta²

2016

JAREM

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Gastroesophageal reflux (GER) is characterized by the involuntary passage of gastric contents into the esophagus. GER disease is defined as a persistent or intermittent passage of gastric contents into the esophagus, which often results in overt clinical signs and symptoms and affects the quality of life. GER is a common disorder in childhood and has a good prognosis. GER in infancy begins within the first month of life, peaks at the 4 th month, and after the first year, it steadily decreases and finally resolves at the age of 2 years. GER physiologically occurs due to the relaxation of the lower esophageal sphincter, independent of swallowing. The mechanisms against GER include the following; 1. Lower esophageal sphincter dysfunction, 2. Clearance effect of esophagus, 3. Esophageal mucosal integrity, and 4. Gastric emptying, which prevent the development of GER disease. Although the physiopathology of GER is still not clearly established, proposed factors are genetic, environmental, anatomic, hormonal, and neurogenic. The most responsible factor is lower esophageal sphincter relaxations. The clinical signs of GER varies with age but commonly appear with gastrointestinal and respiratory symptoms. The diagnosis of GER disease is based on history, physical examination, esophageal pH monitoring, multichannel intraluminal impedance and esophageal manometry, motility examinations, endoscopy, biopsy, examinations with barium, and nuclear scintigraphy. Treatment of GER includes non-pharmacological and pharmacological therapies, such as prokinetic agents and acid suppressors. Surgical treatment indications are relatively limited. (JAREM 2016; 6: 67-73)

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Should domperidone be used for the treatment of gastro‐oesophageal reflux in children? Systematic review of randomized controlled trials in children aged 1 month to 11 years old

Cited by 92 publications

References 12 publications

Treatment of gastroesophageal reflux disease

Treatment of gastroesophageal reflux disease

Short-term effect of domperidone on gastroesophageal reflux in newborns assessed by combined intraluminal impedance and pH monitoring

From Newborn to Teenage: Gastroesophageal Reflux

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