[Assessment of the efficacy and safety of the phytopharmacon STW 5 versus metoclopramide in functional dyspepsia--a retrolective cohort study].
OBJECTIVE
The objective of this study was to assess the efficacy and safety of the phytopharmacon STW 5 versus metoclopramide in functional dyspepsia.


METHODS
A retrolective, epidemiological cohort study with parallel groups in 23 randomised centres where both drugs were used routinely was performed. The main outcome variable was improvement of 10 dyspepsia-specific symptoms of a valid gastrointestinal symptom score (GIS) during therapy. For inclusion, patients had to suffer from at least three of these symptoms before therapy. Secondary outcome variables were change of single symptoms, time till complete symptom relief, investigators' judgement of efficacy and tolerability, duration of inability to work and occurrence of adverse events.


RESULTS
The per protocol collective comprised 490 STW 5 and 471 MCP patients. Anamnestic data were comparable. 439 of patients had taken MCP as drops. There was no relevant difference in median treatment duration. Significantly more patients were symptom-free after STW 5 treatment (71.6 vs. 62.8% p = 0,012). Additionally, the extent of symptom improvement (excluding nausea and vomiting) and median duration of inability to work (1 vs. 3 days) were significantly different in favour of STW 5. More physicians assessed STW 5 as effective (71.6 vs. 63.1% p<0.01) and very well tolerated (90 vs. 70.6% p<0.001). Adverse drug reactions were documented only under MCP.


CONCLUSIONS
The present study illustrates a comparable to higher efficacy of STW 5 vs. MCP with better tolerability in treating functional dyspepsia under practice conditions, especially regarding complete symptom improvement, symptom duration and quality of life. The study confirms the results of prospective trials for STW 5 as being an appropriate alternative to the frequently administered antacids and prokinetics.
Raedsch
R
R
St.-Josefs-Hospital, Med. Klinik II, Gastroenterologie, Wiesbaden/Deutschland. rraedsch@joho.de
Hanisch
J
J
Bock
P
P
Sibaev
A
A
Vinson
B
B
Gundermann
K-J
KJ
D000932:Antiemetics / Q000627:therapeutic use; D015331:Cohort Studies; D004415:Dyspepsia / Q000188:drug therapy* / Q000453:epidemiology*; D006801:Humans; D038622:Internationality; D008787:Metoclopramide / Q000627:therapeutic use*; D010936:Plant Extracts / Q000627:therapeutic use*; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D016896:Treatment Outcome
D000932:Antiemetics; D010936:Plant Extracts; C039964:iberogast; D008787:Metoclopramide