Comparative evaluation of itopride and domperidone in gastroesophageal reflux disease
Keywords:
Itopride, Domperidone, Gastroesophageal reflux diseaseAbstract
Background: Gastroesophageal reflux disease (GERD) presents in various ways in terms of symptoms and severity. This study was conducted to assess the severity of GERD patients and to evaluate the effect of itopride and domperidone on symptoms and severity of GERD.
Methods: A single-blind study was carried out in 70 patients. Group A (n=35) patients were kept on itopride therapy, 50 mg thrice a day before meal. Group B (n=35) patients were kept on domperidone therapy, 10 mg thrice a day before meal. Patients of both groups were given rabeprazole, 20 mg once a day for hyperacidity. Patients served their own control. Each patient was followed-up at 2 weeks interval up to 8 weeks.
Results: The most common symptom was heartburn, present in 95.71% patients. Regurgitation was the next most common symptom (65.71%). The most common lesion seen endoscopically (according to Savary Miller classification) was grade I (38.57%). In 24.29% patient, only symptoms of GERD were present without any endoscopically visible mucosal injury. At the end of 2, 4, 6, and 8 weeks, relief of symptoms was more with a combination of itopride and rabeprazole in comparison to the combination of domperidane and rabeprazole, but the difference was statistically insignificant. Healing rate at the end of 4th and 8th week was slight better with a combination of itopride and rabeprazole, but the difference again was statistically insignificant.
Conclusion: Combination of itopride and rabeprazole showed insignificantly better results, both symptomatically and endoscopically in comparison to the combination of domperidone and rabeprazole.
References
Bainbridge ET, Temple JG, Nicholas SP, Newton JR, Boriah V. Symptomatic gastro-oesophageal reflux in pregnancy. A comparative study of white Europeans and Asians in Birmingham. Br J Clin Pract. 1983;37(2):53-7.
Wienbeck M, Barnert J. Epidemiology of reflux disease and reflux esophagitis. Scand J Gastroenterol Suppl. 1989;156:7-13.
Sonnenberg A, El-Serag HB. Clinical epidemiology and natural history of gastroesophageal reflux disease. Yale J Biol Med. 1999;72(2-3):81-92.
Pope CE II. Gastroesophageal reflux disease (reflux esophagitis). In: Sleisenger MH, Fordtran JS, editors. Gastro Intestinal Disease, Pathophysiology, Diagnosis, Management. 3rd Edition. Philadelphia: WB Saunders; 1983: 449-76.
Castell DO. The lower esophageal sphincter. Physiologic and clinical aspects. Ann Intern Med. 1975;83(3):390-401.
Dent J. A new technique for continuous sphincter pressure measurement. Gastroenterology. 1976;71(2):263-7.
Iwanaga Y, Suzuki N, Kato K, Kimura T, Morikawa K, Kato H, et al. Stimulatory effects of HSR-803 on ileal motor activity. Jpn J Pharmacol. 1993;62(4):395-401.
Kim YS, Kim TH, Choi CS, Shon YW, Kim SW, Seo GS, et al. Effect of itopride, a new prokinetic, in patients with mild GERD: a pilot study. World J Gastroenterol. 2005;11(27):4210-4.
Kakiuchi M, Saito T, Ohara N, Hosotani T, Morikawa K. Pharmacological evaluation of itopride hydrochloride with regard to drug induced arrhythmia. Jpn Pharmacol Ther. 1997;25:822-7.
Kohli JD, Glock D, Goldberg LI. Selective DA2 versus DA1 antagonist activity of domperidone in the periphery. Eur J Pharmacol. 1983;89(1-2):137-41.
Grandy DK, Litt M, Allen L, Bunzow JR, Marchionni M, Makam H, et al. The human dopamine D2 receptor gene is located on chromosome 11 at q22-q23 and identifies a TaqI RFLP. Am J Hum Genet. 1989;45(5):778-85.
Van Nueten J. Effects of domperidone on gastric motility: a study on the isolated stomach of the guinea pig. Janssen Pharmaceutica; Janssen Research Products Information Service Preclinical Research Report; 1977. (R33 812/30).
Weihrauch TR, Förster CF, Krieglstein J. Evaluation of the effect of domperidone on human oesophageal and gastroduodenal motility by intraluminal manometry. Postgrad Med J 1979;55 Suppl 1:7-10.
Hilland U, Bohnet HG, Blank M. Domperidone stimulated prolactin secretion in normal male and female volunteers. Endokrinologie. 1981;77(3):363-6.
Miller LS. Endoscopy of the esophagus. In: Castell DO, editor. The Esophagus. 2nd Edition. Boston: Little, Brown & Co.; 1995: 93-132.
Zhao Y, Encinosa W. Gastroesopageal reflux disease hospitalizations in 1998 and 2005. Statistical Brief # 44. Rockville, MD: Agency for Health Research and Quality; 2008.
Kahrilas PJ, Pandolfino JE. Gastroesophageal reflux disease and its complications including Barrett’s metaplasia. In: Feldman M, Friedman LS, Sleisenger MH, editors. Gastro Intestinal and Liver Disease. 7th Edition. Pennsylvania: Saunders; 2002: 599-622.
Sontag SJ. Gastroesophageal reflux disease. In: Brandt LJ, Daum F, Friedman LS, editors. Clinical Practice of Gastroenterology. Philadelphia: Current Medicine; 1999:21-33.
Holtmann G, Talley NJ, Liebregts T, Adam B, Parow C. A placebo-controlled trial of itopride in functional dyspepsia. N Engl J Med. 2006;354(8):832-40.
Miyoshi A, Masamune O, Sekiguchi T, Asakura H, Sato N, Nakamura T, et al. Clinical evaluation of itopride hydrochloride for gastrointestinal symptoms associated with chronic gastritis: a multicentre double blind clinical trial using cisapride as control drug. Clin Pharmacol Ther. 1994;4(2):261-79.
Dekkers CP, Beker JA, Thjodleifsson B, Gabryelewicz A, Bell NE, Humphries TJ. Double-blind comparison correction of Double-blind, placebo-controlled comparison of rabeprazole 20 mg vs. omeprazole 20 mg in the treatment of erosive or ulcerative gastro-oesophageal reflux disease. The European Rabeprazole Study Group. Aliment Pharmacol Ther. 1999;13(1):49-57.
Shahani S, Sawant P, Dabholkar P. Rabeprazole plus domperidone: the answer for gastro-oesophageal reflux disease. J Indian Med Assoc. 2008;106(4):264, 266, 268.
