title: Mosapride for gastroesophageal reflux disease in neurologically impaired patients.
abstract: BACKGROUND
  The prokinetic agent cisapride is effective for the treatment of gastroesophageal reflux disease (GERD) in infants and children, but is no longer used for this purpose because of safety concerns. Therefore, other pharmacological agents need to be investigated for efficacy in GERD treatment. In this study, we examined the effectiveness and safety of mosapride for the treatment of neurologically impaired children and adolescents with GERD.
  
  
  METHODS
  Mosapride (0.3 mg/kg/day) was administered to 11 neurologically impaired patients with GERD (five male; median age, 12.3 years). Esophageal acid exposure was measured using esophageal pH monitoring before and at >5 days after the start of mosapride treatment. The pressure and length of the lower esophageal sphincter were compared before and after mosapride treatment.
  
  
  RESULTS
  In the 11 patients, median reflux index (percentage of the total monitoring period during which recorded pH was <4.0) was 17.5% (range, 4.4-59%) before and 8.2% (range, 2.8-20.7%) after mosapride treatment (P = 0.02). Median esophageal clearance was 1.0 min/reflux (range, 0.5-2.1 min/reflux) before and 0.7 min/reflux (range, 0.4-1.2 min/reflux) after treatment with mosapride (P = 0.02). The median number of reflux episodes before (219) and after (122) drug treatment did not differ significantly.
  
  
  CONCLUSIONS
  The decreased reflux index in neurologically impaired patients with GERD is due to mosapride, therefore mosapride may be a candidate for GERD treatment.
authors: Department of Pediatric Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
authors: Makoto
authors: M
authors: Komura
authors: Department of Pediatric Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
authors: Yutaka
authors: Y
authors: Kanamori
authors: Department of Pediatric Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
authors: Yujiro
authors: Y
authors: Tanaka
authors: Department of Pediatric Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
authors: Tetsuro
authors: T
authors: Kodaka
authors: Department of Pediatric Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
authors: Masahiko
authors: M
authors: Sugiyama
authors: Department of Pediatric Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
authors: Kan
authors: K
authors: Terawaki
authors: Department of Pediatric Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
authors: Kan
authors: K
authors: Suzuki
authors: Department of Pediatric Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
authors: Tadashi
authors: T
authors: Iwanaka
mesh_terms: D000293:Adolescent; D001549:Benzamides / Q000627:therapeutic use*; D002547:Cerebral Palsy / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D004334:Drug Administration Schedule; D050782:Esophageal pH Monitoring; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D008297:Male; D009025:Morpholines / Q000627:therapeutic use*; D065886:Neurodevelopmental Disorders / Q000150:complications*; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001549:Benzamides; D005765:Gastrointestinal Agents; D009025:Morpholines; C062720:mosapride
keywords: gastroesophageal reflux disease; mosapride; neurologically impaired patient; prokinetic agent