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Prokinetics for functional dyspepsia.

Rapat Pittayanon1, Yuhong Yuan, Natasha P Bollegala

  • 1Department of Medicine, Division of Gastroenterology, McMaster University, Hamilton, ON, Canada.

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|October 19, 2018
PubMed
Summary
This summary is machine-generated.

The efficacy of prokinetics for functional dyspepsia (FD) remains uncertain due to low-quality evidence. While some prokinetics showed symptom improvement, further high-quality randomized controlled trials (RCTs) are needed to confirm their effectiveness and safety.

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Area of Science:

  • Gastroenterology
  • Pharmacology
  • Clinical Trials

Background:

  • Functional dyspepsia (FD) is a common gastrointestinal disorder.
  • Prokinetics are a primary treatment for FD, but their effectiveness is debated.
  • This study systematically reviews prokinetic efficacy in FD.

Purpose of the Study:

  • To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs).
  • To examine the efficacy of prokinetics in treating functional dyspepsia (FD).
  • To evaluate symptom improvement, quality of life (QoL), and adverse events.

Main Methods:

  • Systematic search of multiple databases (MEDLINE, Embase, Cochrane Library, CINAHL) up to September 2017.
  • Meta-analysis of 43 RCTs involving 10,044 participants comparing prokinetics with placebo or other prokinetics.
  • Data analysis using RevMan 5.3 with random-effects models; quality of evidence assessed by GRADE.

Main Results:

  • Prokinetic treatment showed a statistically significant effect in reducing global FD symptoms (RR 0.81), but with very low-quality evidence and high heterogeneity.
  • Subgroup analyses indicated potential benefits for cisapride, acotiamide, and tegaserod.
  • No significant improvement in Quality of Life (QoL) was observed; adverse events were generally similar to placebo, except for cisapride.

Conclusions:

  • The low-quality evidence prevents definitive conclusions on prokinetic efficacy for FD.
  • Uncertainty remains regarding the most effective prokinetic drug and their impact on QoL.
  • High-quality RCTs are essential to establish the true efficacy and safety of prokinetics in FD treatment.