title: Comparison of PPIs and H2-receptor antagonists plus prokinetics for dysmotility-like dyspepsia.
abstract: OBJECTIVE
  To compare efficacy of proton pump inhibitors (PPIs) with H(2)-receptor antagonists (H(2)RAs) plus prokinetics (Proks) for dysmotility-like symptoms in functional dyspepsia (FD).
  
  
  METHODS
  Subjects were randomized to receive open-label treatment with either rabeprazole 10 mg od (n = 57) or famotidine 10 mg bid plus mosapride 5 mg tid (n = 57) for 4 wk. The primary efficacy endpoint was change (%) from baseline in total dysmotility-like dyspepsia symptom score. The secondary efficacy endpoint was patient satisfaction with treatment.
  
  
  RESULTS
  The improvement in dysmotility-like dyspepsia symptom score on day 28 was significantly greater in the rabeprazole group (22.5% ± 29.2% of baseline) than the famotidine + mosapride group (53.2% ± 58.6% of baseline, P < 0.0001). The superior benefit of rabeprazole treatment after 28 d was consistent regardless of Helicobacter pylori status. Significantly more subjects in the rabeprazole group were satisfied or very satisfied with treatment on day 28 than in the famotidine + mosapride group (87.7% vs 59.6%, P = 0.0012). Rabeprazole therapy was the only significant predictor of treatment response (P < 0.0001), defined as a total symptom score improvement ≥ 50%.
  
  
  CONCLUSIONS
  PPI monotherapy improves dysmotility-like symptoms significantly better than H(2)RAs plus Proks, and should be the treatment of first choice for Japanese FD.
authors.affiliation: Department of Gastroenterology, Moriguchi Keijinkai Hospital, Moriguchi, Osaka, Japan. kjsakaguchi@mkc.zaq.ne.jp
authors.forename: Masahiro
authors.initials: M
authors.lastname: Sakaguchi
authors.forename: Miyuki
authors.initials: M
authors.lastname: Takao
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ohyama
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Oka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamashita
authors.forename: Takumi
authors.initials: T
authors.lastname: Fukuchi
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Ashida
authors.forename: Masahiro
authors.initials: M
authors.lastname: Murotani
authors.forename: Masuyo
authors.initials: M
authors.lastname: Murotani
authors.forename: Kazuo
authors.initials: K
authors.lastname: Majima
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Morikawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kiyota
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Esaki
authors.forename: Kanji
authors.initials: K
authors.lastname: Amemoto
authors.forename: Gouhei
authors.initials: G
authors.lastname: Isowa
authors.forename: Fumiyuki
authors.initials: F
authors.lastname: Takao
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D001549:Benzamides / Q000627:therapeutic use; D004415:Dyspepsia / Q000188:drug therapy* / Q000503:physiopathology; D015154:Esophageal Motility Disorders / Q000188:drug therapy* / Q000503:physiopathology; D015738:Famotidine / Q000627:therapeutic use; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D016481:Helicobacter Infections / Q000188:drug therapy; D016480:Helicobacter pylori; D006635:Histamine H2 Antagonists / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009025:Morpholines / Q000627:therapeutic use; D017060:Patient Satisfaction; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D064750:Rabeprazole
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D001549:Benzamides; D005765:Gastrointestinal Agents; D006635:Histamine H2 Antagonists; D009025:Morpholines; D054328:Proton Pump Inhibitors; D064750:Rabeprazole; D015738:Famotidine; C062720:mosapride