Novel Prokinetic Acotiamide Reduces Transient Lower Esophageal Sphincter Relaxation in Healthy Subjects.
OBJECTIVE
Currently, there is no study evaluating the effect of acotiamide on transient lower esophageal sphincter relaxations (TLESRs). The aim of this study was to evaluate the effect of acotiamide on TLESRs using simultaneous high-resolution manometry (HRM) and impedance-pH monitoring.


METHODS
Ten healthy subjects were enrolled. On day 1, subjects underwent HRM and impedance-pH recordings as a baseline. Subjects ate a 750-kcal liquid meal; recording was continued for 2 h while the subjects were in a sitting position. After the administration of acotiamide 100 mg three times a day for 1 week, subjects underwent HRM and impedance-pH recording under the same protocol.


RESULTS
A total of 208 TLESRs were identified at baseline. Acotiamide decreased the total number of TLESRs from 208 to 143 (p < 0.05). The rate of reflux events during TLESRs after acotiamide administration was similar to that at baseline (57% after acotiamide vs. 58% at baseline). Bolus clearance time was significantly reduced by acotiamide.


CONCLUSIONS
Acotiamide was believed to have the potential for reducing TLESRs and for enhancing esophageal bolus clearance in healthy volunteers. Future research is needed to determine whether the effects of acotiamide that reduce TLESRs and enhance esophageal motility could improve symptoms in patients with refractory gastroesophageal reflux disease.
Department of Gastroenterology and Hepatology, Saiseikai Nakatsu Hospital, Osaka, Japan.
Hiroshi
H
Yamashita
Atsushi
A
Kanamori
Takumi
T
Fukuchi
Masahiro
M
Tsujimae
Akio
A
Koizumi
Taro
T
Iwatsubo
Shintaro
S
Koyama
Takaaki
T
Eguchi
Satoshi
S
Ubukata
Mikio
M
Fujita
Akihiko
A
Okada
D000328:Adult; D001549:Benzamides / Q000008:administration & dosage / Q000494:pharmacology*; D017097:Electric Impedance; D049630:Esophageal Sphincter, Lower / Q000187:drug effects*; D005260:Female; D005764:Gastroesophageal Reflux / Q000139:chemically induced / Q000188:drug therapy*; D005765:Gastrointestinal Agents / Q000008:administration & dosage / Q000494:pharmacology*; D005769:Gastrointestinal Motility / Q000187:drug effects; D064368:Healthy Volunteers; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008365:Manometry; D009126:Muscle Relaxation / Q000187:drug effects*; D013844:Thiazoles / Q000008:administration & dosage / Q000494:pharmacology*
D001549:Benzamides; D005765:Gastrointestinal Agents; D013844:Thiazoles; C410959:Z 338