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Efficacy of camostat mesilate against dyspepsia associated with non-alcoholic mild pancreatic disease

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
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Abstract

Background

The aim of the present study was to examine the potential efficacy of camostat mesilate, a protease inhibitor, against dyspepsia associated with non-alcoholic mild pancreatic disease.

Methods

Patients with upper abdominal pain suggesting pancreatic disease (persistent over hours, pain aggravated by ingestion of food, epigastric pain radiating to the back), without a history of alcohol consumption and who exhibited no abnormalities regarding serum amylase and lipase, ultrasonography, CT and upper gastrointestinal endoscopy, were prescribed 200 mg camostat mesilate three times daily for 2 weeks. The patients were subjected to endoscopic ultrasonography (EUS) while under treatment and were distributed into those who had 4 or more suggestive findings of chronic pancreatitis (suspected pancreatic disease group), 2 or 3 (equivalent group) and those with 1 or no findings (control group). Symptom severity was recorded before and after treatment using a 10-cm visual analog scale (VAS).

Results

Among 95 patients, 40 were in the suspected pancreatic disease group, 30 were in the equivalent group and 25 served as controls. A significant intra- and intergroup improvement of symptoms was observed not only in the suspected pancreatic disease group but also in the equivalent group.

Conclusions

Camostat mesilate may serve as a therapeutic agent for patients with dyspepsia associated with mild pancreatic disease, who do not habitually drink alcohol.

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References

  1. Talley NJ, Stanghellini V, Heading RC, Koch KL, Malagelada JR, Tytgat GN. Functional gastroduodenal disorders. Gut. 1999;45(Suppl. 2):II37–42.

    Article  PubMed  Google Scholar 

  2. El-Serag HB, Talley NJ. Systemic review: the prevalence and clinical course of functional dyspepsia. Aliment Pharmacol Ther. 2004;19:643–54.

    Article  CAS  PubMed  Google Scholar 

  3. Tack J, Talley NJ, Camilleri M, Holtmann G, Hu P, Malagelada JR, et al. Functional gastroduodenal disorders. Gastroenterology. 2006;130:1466–79.

    Article  PubMed  Google Scholar 

  4. Drossman DA. The functional gastrointestinal disorders and the Rome III process. Gastroenteology. 2006;130:1377–90.

    Article  Google Scholar 

  5. Sahai AV, Mishra G, Penman ID, Williams D, Wallace MB, Hadzijahic N, et al. EUS to detect evidence of pancreatic disease in patients with persistent or nonspecific dyspepsia. Gastrointest Endosc. 2000;52:153–9.

    Article  CAS  PubMed  Google Scholar 

  6. DeWitt J, McGreevy K, LeBlanc J, McHenry L, Cummings O, Sherman S. EUS-guided Trucut biopsy of suspected nonfocal chronic pancreatitis. Gastrointest Endosc. 2005;62:76–84.

    Article  PubMed  Google Scholar 

  7. Chong AK, Hawes RH, Hoffman BJ, Adams DB, Lewin DN, Romagnuolo J. Diagnostic performance of EUS for chronic pancreatitis: a comparison with histopathology. Gastrointest Endosc. 2007;65:808–14.

    Article  PubMed  Google Scholar 

  8. Otsuki M, Tani S, Okabayashi Y, Fuji M, Nakamura T, Fujisawa T, et al. Beneficial effects of the synthetic trypsin inhibitor camostat in cerulein-induced acute pancreatitis in rats. Dig Dis Sci. 1990;35:242–50.

    Article  CAS  PubMed  Google Scholar 

  9. Gibo J, Ito T, Kawabe K, Hisano T, Inoue M, Fujimori N, et al. Camostat mesilate attenuates pancreatic fibrosis via inhibition of monocytes and pancreatic stellate cells activity. Lab Invest. 2005;85:75–89.

    CAS  PubMed  Google Scholar 

  10. Emori Y, Mizushima T, Matsumura N, Ochi K, Tanioka H, Shirahige A, et al. Camostat, an oral trypsin inhibitor, reduces pancreatic fibrosis induced by repeated administration of a superoxide dismutase inhibitor in rats. J Gastroenterol Hepatol. 2005;20:895–9.

    CAS  PubMed  Google Scholar 

  11. Ashizawa N, Hashimoto T, Miyake T, Shizuku T, Imaoka T, Kinoshita Y. Efficacy of camostat mesilate compared with famotidine for treatment of functional dyspepsia: is camostat mesilate effective? J Gastroenterol Hepatol. 2006;21:767–71.

    Article  CAS  PubMed  Google Scholar 

  12. Sahai AV, Zimmerman M, Aabakken L, Tarnasky PR, Cunningham JT, van Velse A, et al. Prospective assessment of the ability of endoscopic ultrasound to diagnose, exclude, or establish the severity of chronic pancreatitis found by endoscopic retrograde cholangiopancreatography. Gastrointest Endosc. 1998;48:18–25.

    Article  CAS  PubMed  Google Scholar 

  13. Lees WR. Endoscopic ultrasonography of chronic pancreatitis and pancreatic pseudocysts. Scand J Gastroenterol Suppl. 1986;123:123–9.

    Article  CAS  PubMed  Google Scholar 

  14. Zuccaro G Jr, Sivak MV Jr. Endoscopic ultrasonography in the diagnosis of chronic pancreatitis. Endoscopy. 1992;24:347–9.

    Article  PubMed  Google Scholar 

  15. Wiersema MJ, Hawes RH, Lehman GA, Kochman ML, Sherman S, Kopecky KK. Prospective evaluation of endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography in patients with chronic abdominal pain of suspected pancreatic origin. Endoscopy. 1993;25:555–64.

    Article  CAS  PubMed  Google Scholar 

  16. Varadarajulu S, Eltoum I, Tamhane A, Eloubeidi MA. Histopathologic correlates of noncalcific chronic pancreatitis by EUS: a prospective tissue characterization study. Gastrointest Endosc. 2007;66:501–9.

    Article  PubMed  Google Scholar 

  17. Savides TJ, Gress FG, Zaidi SA, Ikenberry SO, Hawes RH. Detection of embryologic ventral pancreatic parenchyma with endoscopic ultrasound. Gastrointest Endosc. 1996;43:14–9.

    CAS  PubMed  Google Scholar 

  18. Talley NJ, Vakil N, Practice Parameters Committee of the American College of Gastroenterology. Guidelines for the management of dyspepsia. Am J Gastroenterol. 2005;100:2324–37.

    Article  PubMed  Google Scholar 

  19. Agreus L, Svardsudd K, Nyren O, Tibblin G. Irritable bowel syndrome and dyspepsia in the general population: overlap and lack of stability over time. Gastroenterology. 1995;109:671–80.

    Article  CAS  PubMed  Google Scholar 

  20. Williams B, Luckas M, Ellingham JH, Dain A, Wicks AC. Do young patients with dyspepsia need investigation? Lancet. 1988;2(8624):1349–51.

    Article  CAS  PubMed  Google Scholar 

  21. Talley NJ, McNeil D, Hayden A, Colreavy C, Piper DW. Prognosis of chronic unexplained dyspepsia. A prospective study of potential predictor variables in patients with endoscopically diagnosed nonulcer dyspepsia. Gastroenterology. 1987;92:1060–6.

    CAS  PubMed  Google Scholar 

  22. Forsmark CE. The diagnosis of chronic pancreatitis. Gastrointest Endosc. 2000;52:293–8.

    Article  CAS  PubMed  Google Scholar 

  23. Bozkurt T, Braun U, Leferink S, Gilly G, Lux G. Comparison of pancreatic morphology and exocrine functional impairment in patients with chronic pancreatitis. Gut. 1994;35:1132–6.

    Article  CAS  PubMed  Google Scholar 

  24. Andersen BN, Scheel J, Rune SJ, Worning H. Exocrine pancreatic function in patients with dyspepsia. Hepatogastroenterology. 1982;29:35–7.

    CAS  PubMed  Google Scholar 

  25. Smith RC, Talley NJ, Dent OF, Jones M, Waller SL. Exocrine pancreatic function and chronic unexplained dyspepsia. A case–control study. Int J Pancreatol. 1991;8:253–62.

    CAS  PubMed  Google Scholar 

  26. Irisawa A, Mishra G, Hernandez LV, Bhutani MS. Quantitive analysis of endosonographic parenchymal echogenecity in patients with chronic pancreatitis. J Gastroenterol Hepatol. 2004;19:1199–205.

    Article  PubMed  Google Scholar 

  27. Catalano MF, Lahoti S, Geenen JE, Hogan WJ. Prospective evaluation of endoscopic ultrasonography, endoscopic retrograde pancreatography, and secretin test in the diagnosis of chronic pancreatitis. Gastrointest Endosc. 1998;48:11–7.

    Article  CAS  PubMed  Google Scholar 

  28. Wallace MB, Hawes RH, Durkalski V, Chak A, Mallery S, Catalano MF, et al. The reliability of EUS for the diagnosis of chronic pancreatitis: interobserver agreement among experienced endosonographers. Gastrointest Endosc. 2001;53:294–9.

    CAS  PubMed  Google Scholar 

  29. Catalano MF, Sahai A, Levy M, Romagnuolo J, Wiersema M, Brugge W, et al. EUS-based criteria for the diagnosis of chronic pancreatitis: the Rosemont classification. Gastrointest Endosc. 2009;69:1251–61.

    Article  PubMed  Google Scholar 

  30. Hirano K, Nakazawa S, Tomita T. Effects of gabexate, a protease inhibitor, on smooth muscle of guinea-pig stomach fundus. Pharmacol Toxicol. 1995;76:102–6.

    Article  CAS  PubMed  Google Scholar 

  31. Ito T, Kamada T. Clinical research for new evidence of possible chronic pancreatitis (in Japanese). Shoukakika. 2003;36:515–22.

    Google Scholar 

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Authors and Affiliations

  1. Department of Gastroenterology, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan

    Jin Kan Sai, Masafumi Suyama, Yoshihiro Kubokawa, Yuji Matsumura, Koichi Inami & Sumio Watanabe

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  1. Jin Kan Sai
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  2. Masafumi Suyama
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  3. Yoshihiro Kubokawa
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  4. Yuji Matsumura
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  5. Koichi Inami
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  6. Sumio Watanabe
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Correspondence to Jin Kan Sai.

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Sai, J.K., Suyama, M., Kubokawa, Y. et al. Efficacy of camostat mesilate against dyspepsia associated with non-alcoholic mild pancreatic disease. J Gastroenterol 45, 335–341 (2010). https://doi.org/10.1007/s00535-009-0148-1

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  • DOI: https://doi.org/10.1007/s00535-009-0148-1

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