The effect of mosapride on oesophageal motor function and acid reflux in patients with gastro-oesophageal reflux disease.
OBJECTIVE
To evaluate the efficiency of the 5-HT4 agonist and 5-HT3 antagonist mosapride, as compared with cisapride, on oesophageal acid reflux variables and oesophageal motor function in patients with chronic gastro-oesophageal reflux disease (GORD).


METHODS
Forty-one patients with proven GORD were included in a double-blind, randomised, double-dummy, three-way crossover study. All patients received mosapride 60 mg twice daily, mosapride 30 mg three times daily, and cisapride 20 mg twice daily for seven days in a randomised order, separated by a washout period of at least five days. Twenty-three patients underwent four combined ambulatory 24-h motility and pH recordings within two weeks before the start of treatment and on day seven of each treatment period. The remaining 18 patients underwent three ambulatory 24-h pH recordings only, i.e. on treatment day seven of each treatment period.


RESULTS
Mosapride had no significant effect on the total number of contractions in the oesophagus, or on the effectiveness, or possible effectiveness, of the propagations. Significant but numerically small effects on peristaltic durations and amplitudes were noted during both mosapride and cisapride treatment as compared with baseline values. The effect on acid reflux for both mosapride and cisapride was most pronounced for the duration of the longest reflux episode. The fraction of time with pH less than 4 was reduced by mosapride 30 mg three times daily in the supine position and by cisapride both totally and in the supine position. The number of reflux episodes was reduced significantly only by cisapride. Oesophageal clearance was reduced significantly by cisapride only in the supine position.


CONCLUSIONS
Mosapride had small but statistically significant effects, comparable to those of cisapride, on acid reflux variables and oesophageal motor function in patients with GORD.
D000328:Adult; D000368:Aged; D001549:Benzamides / Q000627:therapeutic use*; D020117:Cisapride / Q000627:therapeutic use; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004947:Esophagus / Q000187:drug effects* / Q000503:physiopathology; D005260:Female; D005764:Gastroesophageal Reflux / Q000188:drug therapy* / Q000503:physiopathology; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D006863:Hydrogen-Ion Concentration / Q000187:drug effects; D008297:Male; D008365:Manometry; D008875:Middle Aged; D009025:Morpholines / Q000627:therapeutic use*; D010528:Peristalsis / Q000187:drug effects*; D058831:Serotonin 5-HT3 Receptor Antagonists; D058828:Serotonin 5-HT4 Receptor Agonists
D001549:Benzamides; D005765:Gastrointestinal Agents; D009025:Morpholines; D058831:Serotonin 5-HT3 Receptor Antagonists; D058828:Serotonin 5-HT4 Receptor Agonists; C062720:mosapride; D020117:Cisapride