当前位置： SCI文献检索 > SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY期刊下所有文献 > The effect of cisapride in maintaining symptomatic remission in patients with gastro-oesophageal reflux disease.

The effect of cisapride in maintaining symptomatic remission in patients with gastro-oesophageal reflux disease.

Abstract：

BACKGROUND:Successful treatment of gastro-oesophageal reflux disease (GORD) has traditionally been assessed as healing of reflux oesophagitis, which may not be relevant in patients with moderate disease. In these patients symptom relief and patient satisfaction with therapy are of fundamental importance. Cisapride has well-documented prokinetic effects and may be well suited for long-term therapy of GORD, but its effectiveness in purely symptomatic treatment is unknown. We therefore compared two dosage regimens of cisapride with placebo over a period of 6 months in patients with evidence of gastrooesophageal reflux, initially treated with antisecretory medication, with regard to maintaining symptom relief and satisfaction with treatment. METHODS:Five hundred and thirty-five patients with reflux oesophagitis grade 1 (n = 293) or 2 (n = 124) or with no reflux oesophagitis but pathologic 24-h pH-metry (n = 118) achieved satisfactory symptom relief with an H2-receptor antagonist or proton pump inhibitor within 4-8 weeks. In a double-blind randomized, parallel-group study, they were then treated with cisapride, 20 mg at night or 20 mg twice daily, or placebo and followed up for a maximum period of 6 months. Relapse was defined as dissatisfaction with therapy or an average consumption of more than two antacid tablets a day. RESULTS:Median time to relapse was 63 days for cisapride, 20 mg twice daily; 59 days for cisapride, 20 mg at night; and 49 days for placebo. Time to relapse was not significantly different (P = 0.09). Presence and grade of oesophagitis at base line, type of therapy before randomization, and pattern of non-reflux symptoms at base line did not influence these findings significantly. CONCLUSION:The study indicates that cisapride is of limited value in maintenance therapy of GORD in patients in whom symptom relief has been accomplished with potent antisecretory medication. This 'step-down' approach to therapy seems disadvantageous in the long-term therapy of GORD.

journal_name

Scand J Gastroenterol

journal_title

Scandinavian journal of gastroenterology

authors

Hatlebakk JG,Johnsson F,Vilien M,Carling L,Wetterhus S,Thøgersen T

doi

10.3109/00365529709002988

subject

Has Abstract

pub_date

1997-11-01 00:00:00

pages

1100-6

issue

eissn

0036-5521

issn

1502-7708

journal_volume

pub_type

临床试验,杂志文章,多中心研究,随机对照试验

在线工具

The effect of cisapride in maintaining symptomatic remission in patients with gastro-oesophageal reflux disease.