The Effect of Itopride, a New Prokinetic, on Acid Reflux Symptoms and Variables in Patients with GERD

Choi, Suck Chei; Kim, Tae Hyeon; Kim, Hee Sik; Im, Chong Ju; Yoo, Kyo Sang; Sohn, Young Woo; Yeom, Joo Jin; Kim, Yong Sung; Kim, Sang Wook; Seo, Geom Seog; Nah, Yong Ho

Abstract

BACKGROUND/AIMS
Itopride is a newly developed prokinetic agent enhancing gastric motility through both antidopaminergic and anti-acetylcholinesterase actions. The importance of esophageal motor dysfunction in the pathogenesis of gastro-esophageal reflux disease (GERD) makes it interesting to examine the effect of itopride on esophageal acid exposure.
METHODS
The effect of itopride on esophageal 24-hour acid reflux variables was studied in 26 patients with GERD symptoms, pre-entry total acid exposure time (pH<4) of more than 5% and mild esophagitis (Savary-Miller grade I, II) by endoscopy. Ambulatory 24-hour pH monitoring and symptom assessment were performed after treatment with itopride 50 mg or 100 mg t.i.d for 4 weeks by a randomization allocation schedule with an open label.
RESULTS
In both itopride groups, total symptom scores were decreased after treatment significantly. Itopride 300 mg was significantly more effective than 150 mg in decreasing the total time and total percent time of intraesophageal pH below 4, and DeMeester score. Consequently, no serious adverse effects were reported after administration in both groups.
CONCLUSIONS
Itopride 100 mg t.i.d is effective to decrease pathologic reflux in patients with GERD. Therefore, it has a therapeutic potential for this diseases.