Shinozaki Medical Clinic, Utsunomiya, Japan.
Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan.
Digestion. 2020;101(4):382-390. doi: 10.1159/000500134. Epub 2019 May 7.
BACKGROUND/AIMS: The long-term outcomes of patients after cessation of acotiamide therapy in patients with functional dyspepsia remains unclear. The aim of this study is to investigate the timing and predictors of recurrence of dyspepsia symptoms after cessation of acotiamide therapy for functional dyspepsia.
Seventy patients treated with acotiamide for functional dyspepsia who then ceased treatment were enrolled. Changes in dyspepsia symptoms were evaluated using the Izumo scale, a self-reporting questionnaire of abdominal symptom-related quality of life. Patients were subclassified into epigastric pain, postprandial distress, and overlapped types.
The mean follow-up after cessation of acotiamide was 1.9 years. After cessation of acotiamide, 39 patients (56%) had recurrence. Kaplan-Meier analysis revealed a recurrence-free rate of 51% at 1 year. Predictors of recurrence evaluated with a Cox proportional hazards model showed that overlapped-type dyspepsia and consultation with the treating physician before cessation were identified as significant positive and negative predictors, respectively (p < 0.05). The resumption of acotiamide significantly decreased the score for dyspepsia symptoms at 1 month.
Dyspepsia symptoms recur about one year after cessation of acotiamide therapy. Patients with overlapped-type dyspepsia should be carefully followed after cessation. Patients should consult their treating physician before stopping acotiamide.
背景/目的:功能性消化不良患者停止服用阿考替胺后,其长期预后尚不清楚。本研究旨在探讨功能性消化不良患者停止阿考替胺治疗后,消化不良症状复发的时间和预测因素。
共纳入 70 例接受阿考替胺治疗的功能性消化不良患者,随后停止治疗。采用 Izumo 量表(一种自评腹部症状相关生活质量问卷)评估消化不良症状的变化。患者被分为上腹痛、餐后不适和重叠型。
停止阿考替胺治疗后的平均随访时间为 1.9 年。停止阿考替胺治疗后,39 例(56%)患者出现复发。Kaplan-Meier 分析显示,1 年后无复发率为 51%。使用 Cox 比例风险模型评估的复发预测因素显示,重叠型消化不良和停止治疗前咨询治疗医生分别为显著的阳性和阴性预测因素(p < 0.05)。重新开始服用阿考替胺可显著降低 1 个月时的消化不良症状评分。
停止阿考替胺治疗约 1 年后,消化不良症状复发。停止治疗后,重叠型消化不良患者应密切随访。患者在停止服用阿考替胺之前应咨询其治疗医生。