Efficacy of Serotonin Receptor Agonists in the Treatment of Functional Dyspepsia: a Meta-analysis

Overview

Journal Arch Med Sci

Specialty General Medicine

Date 2019 Jan 31

PMID 30697251

Citations 8

Authors

Man Jin

Yali Mo

Kaisheng Ye

Mingxian Chen

Yi Liu

Cao He

Affiliations

Soon will be listed here.

Abstract

Introduction: Functional dyspepsia (FD) is typically treated with serotonin receptor (5-HT) agonists such as cisapride, mosapride, tegaserod and tandospirone citrate. However, there are conflicting efficacy data, possibly due to significant heterogeneity between studies. In this meta-analysis, we analyzed the efficacy and safety data from studies evaluating the efficacy of serotonin receptor agonists in patients with FD.

Material And Methods: Relevant studies were selected from the Medline, Cochrane, EMBASE, and Google Scholar databases. The meta-analysis included 10 RCTs which evaluated the efficacy of serotonin receptor agonists in patients with FD (final total of 892 patients in the serotonin receptor agonist group, and 640 participants in the placebo group). The primary outcomes were the response rates and abdominal symptoms score. The Cochrane Collaboration's tool was used to assess risk. Sensitivity analysis was carried out using the leave-one-out approach.

Results: Patients treated with serotonin receptor agonists had a significantly higher response rate compared to placebo-treated patients (pooled OR = 2.99; 95% CI: 1.15-7.77; = 0.025). Patients treated with serotonin receptor agonists had a significant improvement in symptom scores compared to the placebo group (pooled standardized mean difference = -0.43; 95% CI: -0.83 to -0.04; = 0.031). Sensitivity analysis indicated that the pooled estimates for abdominal symptom score might be affected by the Yeoh (1997) study.

Conclusions: Serotonin receptor agonists had a significantly higher efficacy compared to placebo in the treatment of FD.

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References

Talley N, Stanghellini V, Heading R, Koch K, Malagelada J, Tytgat G . Functional gastroduodenal disorders. Gut. 1999; 45 Suppl 2:II37-42. PMC: 1766695. DOI: 10.1136/gut.45.2008.ii37. View

Moayyedi P, Soo S, Deeks J, Forman D, Mason J, Innes M . Systematic review and economic evaluation of Helicobacter pylori eradication treatment for non-ulcer dyspepsia. Dyspepsia Review Group. BMJ. 2000; 321(7262):659-64. PMC: 27478. DOI: 10.1136/bmj.321.7262.659. View

Veldhuyzen van Zanten S, Jones M, Verlinden M, Talley N . Efficacy of cisapride and domperidone in functional (nonulcer) dyspepsia: a meta-analysis. Am J Gastroenterol. 2001; 96(3):689-96. DOI: 10.1111/j.1572-0241.2001.03521.x. View

Allescher H, Bockenhoff A, Knapp G, Wienbeck M, Hartung J . Treatment of non-ulcer dyspepsia: a meta-analysis of placebo-controlled prospective studies. Scand J Gastroenterol. 2001; 36(9):934-41. DOI: 10.1080/003655201750305440. View

Redstone H, Barrowman N, Veldhuyzen van Zanten S . H2-receptor antagonists in the treatment of functional (nonulcer) dyspepsia: a meta-analysis of randomized controlled clinical trials. Aliment Pharmacol Ther. 2001; 15(9):1291-9. DOI: 10.1046/j.1365-2036.2001.01044.x. View

Gisbert J, Calvet X, Gabriel R, Pajares J . [Helicobacter pylori infection and functional dyspepsia. Meta-analysis of efficacy of eradication therapy]. Med Clin (Barc). 2002; 118(11):405-9. DOI: 10.1016/s0025-7753(02)72403-2. View

Hallerback B, Bommelaer G, Bredberg E, Campbell M, Hellblom M, Lauritsen K . Dose finding study of mosapride in functional dyspepsia: a placebo-controlled, randomized study. Aliment Pharmacol Ther. 2002; 16(5):959-67. DOI: 10.1046/j.1365-2036.2002.01236.x. View

Talley N . American Gastroenterological Association medical position statement: evaluation of dyspepsia. Gastroenterology. 2005; 129(5):1753-5. DOI: 10.1053/j.gastro.2005.09.019. View

Degen L, Petrig C, Studer D, Schroller S, Beglinger C . Effect of tegaserod on gut transit in male and female subjects. Neurogastroenterol Motil. 2005; 17(6):821-6. DOI: 10.1111/j.1365-2982.2005.00715.x. View

10.

Tack J, Talley N, Camilleri M, Holtmann G, Hu P, Malagelada J . Functional gastroduodenal disorders. Gastroenterology. 2006; 130(5):1466-79. DOI: 10.1053/j.gastro.2005.11.059. View

11.

Moayyedi P, Soo S, Deeks J, Delaney B, Innes M, Forman D . Pharmacological interventions for non-ulcer dyspepsia. Cochrane Database Syst Rev. 2006; (4):CD001960. DOI: 10.1002/14651858.CD001960.pub3. View

12.

Gershon M, Tack J . The serotonin signaling system: from basic understanding to drug development for functional GI disorders. Gastroenterology. 2007; 132(1):397-414. DOI: 10.1053/j.gastro.2006.11.002. View

13.

Hiyama T, Yoshihara M, Matsuo K, Kusunoki H, Kamada T, Ito M . Meta-analysis of the effects of prokinetic agents in patients with functional dyspepsia. J Gastroenterol Hepatol. 2007; 22(3):304-10. DOI: 10.1111/j.1440-1746.2006.04493.x. View

14.

Hiyama T, Yoshihara M, Matsuo K, Kusunoki H, Kamada T, Ito M . Treatment of functional dyspepsia with serotonin agonists: a meta-analysis of randomized controlled trials. J Gastroenterol Hepatol. 2007; 22(10):1566-70. DOI: 10.1111/j.1440-1746.2006.04723.x. View

15.

Talley N . Drug treatment of functional dyspepsia. Scand J Gastroenterol Suppl. 1991; 182:47-60. View

16.

Tack J, Van Den Elzen B, Tytgat G, Wajs E, van Nueten L, De Ridder F . A placebo-controlled trial of the 5-HT1A agonist R-137696 on symptoms, visceral hypersensitivity and on impaired accommodation in functional dyspepsia. Neurogastroenterol Motil. 2009; 21(6):619-26, e23-4. DOI: 10.1111/j.1365-2982.2008.01260.x. View

17.

Miwa H, Nagahara A, Tominaga K, Yokoyama T, Sawada Y, Inoue K . Efficacy of the 5-HT1A agonist tandospirone citrate in improving symptoms of patients with functional dyspepsia: a randomized controlled trial. Am J Gastroenterol. 2009; 104(11):2779-87. DOI: 10.1038/ajg.2009.427. View

18.

Vakil N, Kianifard F, Bottoli I . Exploratory Study of Tegaserod for Dyspepsia in Women Receiving PPIs for Heartburn. Arch Drug Inf. 2009; 1(3):79-88. PMC: 2710991. DOI: 10.1111/j.1753-5174.2008.00012.x. View

19.

Tack J, Janssen P, Bisschops R, Vos R, Phillips T, Tougas G . Influence of tegaserod on proximal gastric tone and on the perception of gastric distention in functional dyspepsia. Neurogastroenterol Motil. 2010; 23(2):e32-9. DOI: 10.1111/j.1365-2982.2010.01613.x. View

20.

Sterne J, Sutton A, Ioannidis J, Terrin N, Jones D, Lau J . Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials. BMJ. 2011; 343:d4002. DOI: 10.1136/bmj.d4002. View