Jung Hye-Kyung, Lee Kwang Jae, Choi Myung-Gyu, Park Hyojin, Lee Joon Seong, Rhee Poong-Lyul, Kim Nayoung, Park KyungSik, Choi Suck Chei, Lee Oh Young, Huh Kyu Chan, Song Geun Am, Hong Su Jin, Sohn Chong Il, Jung Hwoon-Yong, Lee Yong Chan, Rew Jong Sun, Jee Sam Ryong, Kwon Joong Goo
Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
Department of Gastroenterology, Ajou University School of Medicine, Suwon, Gyeonggi-do, Korea.
J Neurogastroenterol Motil. 2016 Apr 30;22(2):254-63. doi: 10.5056/jnm15178.
BACKGROUND/AIMS: The effect of proton pump inhibitors (PPI) in Asian functional dyspepsia (FD) patients has not been well established as in Westerncountries. DA-9701, a novel prokinetic agent, stimulates gastric emptying and modulates visceral hypersensitivity in vivo and in human studies. This study was conducted to compare the efficacy of DA-9701 with a conventional PPI in mono or combination therapy in patients with FD.
In this double-blind, randomized, non-inferiority trial, 389 patients diagnosed with FD using Rome III criteria were allocated among3 groups: 30-mg DA-9701 t.i.d (means 3 times a day), 40-mg pantoprazole, and 30-mg DA-9701 t.i.d + 40-mg pantoprazole. Theprimary efficacy end-point was a global assessment of the patient binary response or response on a 5-Likert scale after 4 weeks.
The global symptomatic improvement was 60.5% in the DA-9701 group, 65.6% in the pantoprazole group, and 63.5% in the DA-9701 + pantoprazole group using a 5-Likert scale at week 4 with no significant difference among 3 groups (P = 0.685). Symptomimprovement measured by binary outcome was significantly achieved in each of the 3 groups, but not different among groups.Patients in all treatment groups reported significant improvement in the response rate and symptoms according to FD subtypes anddyspepsia-related quality of life (P < 0.001), but there were no significant differences among the 3 groups.
DA-9701 improves global and individual symptoms and increases dyspepsia-specific quality of life in patients with FD. The efficacyof DA-9701 monotherapy is comparable with pantoprazole and there is no additive effect with combination of DA-9701 andpantoprazole in patients with FD.
背景/目的:质子泵抑制剂(PPI)在亚洲功能性消化不良(FD)患者中的疗效尚未像在西方国家那样得到充分证实。新型促动力药物DA-9701在体内和人体研究中可刺激胃排空并调节内脏超敏反应。本研究旨在比较DA-9701与传统PPI在FD患者单药治疗或联合治疗中的疗效。
在这项双盲、随机、非劣效性试验中,389例符合罗马III标准诊断为FD的患者被分为3组:每日3次服用30mg DA-9701、每日服用40mg泮托拉唑、每日3次服用30mg DA-9701加40mg泮托拉唑。主要疗效终点是4周后患者二元反应或5级李克特量表反应的整体评估。
在第4周时,使用5级李克特量表评估,DA-9701组的整体症状改善率为60.5%,泮托拉唑组为65.6%,DA-9701加泮托拉唑组为63.5%,3组之间无显著差异(P = 0.685)。通过二元结局测量的症状改善在3组中均显著实现,但组间无差异。所有治疗组的患者根据FD亚型和消化不良相关生活质量报告反应率和症状均有显著改善(P < 0.001),但3组之间无显著差异。
DA-9701可改善FD患者的整体和个体症状,并提高消化不良特异性生活质量。DA-9701单药治疗的疗效与泮托拉唑相当,DA-9701与泮托拉唑联合应用对FD患者无附加效应。