Effects of acotiamide on esophageal motility in healthy subjects: a randomized, double-blind, placebo-controlled crossover study
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Acotiamide is a new drug that exhibits prokinetic activity by enhancing the release of acetylcholine. However, its effects on esophageal motility currently remain unknown. Therefore, we herein investigated the effects of acotiamide on esophageal motility in healthy, asymptomatic subjects.
Thirty healthy subjects received 100 mg of acotiamide or placebo three times a day for 7 days separated by a 28-day washout period in a randomized, double-blind, placebo-controlled crossover study. On the seventh day of treatment, esophagogastric junction pressure, integrated relaxation pressure, and primary peristalsis were assessed using high-resolution manometry.
Esophagogastric junction pressure was significantly higher in the acotiamide group (median 28.2 mmHg) than in the placebo group (24.0 mmHg), whereas no significant differences were observed in integrated relaxation pressure, the distal contractile integral, or contraction patterns between the two groups. Among 13 healthy subjects with peristaltic abnormalities, no significant differences were noted in integrated relaxation pressure or the distal contractile integral between the acotiamide and placebo groups; however, the esophagogastric junction pressure (acotiamide 23.4 mmHg; placebo 21.7 mmHg) significantly increased, the contraction pattern significantly improved, and the frequency of esophageal peristaltic abnormalities significantly decreased in the acotiamide group.
Acotiamide improves the peristaltic pattern in patients with peristaltic abnormalities by decreasing weak peristalsis with a small break.
KeywordsAcotiamide Esophageal motility Lower esophageal sphincter pressure Primary peristalsis
Compliance with ethical standards
All procedures followed were in accordance with the approval of the Ethics Committee of Nippon Medical School Chiba Hokusoh Hospital and the guidelines set forth in the Declaration of Helsinki revised in 2000. Informed consent was obtained from all subjects included in the study.
Conflict of interest
Katsuhiko Iwakiri has received lecture fees from Zeria Pharmaceutical Co., Ltd. The remaining authors declare that they have no conflicts of interest.
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