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Effect of Mosapride Citrate on Gastric Emptying in Interferon-Induced Gastroparesis

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Abstract

Background and Objectives

Gastroparesis, a gastrointestinal autonomic neuropathy, is a common adverse reaction in chronic hepatitis C (CHC) patients receiving interferon therapy. Current therapeutic options are limited. We evaluated the efficacy of mosapride for IFN-induced gastroparesis.

Methods

Twenty-four consecutive CHC patients were randomly assigned to either the control group, which received pegylated interferon α-2b at 1.5 μg/kg/week and ribavirin at 600–1,000 mg/day, depending on body weight (PegIFN/RBV), or the mosapride group, which received PegIFN/RBV plus mosapride at 15 mg/person/day. The solid-phase gastric emptying half-times (T1/2) of the total, proximal, and distal stomach (scintigraphy) and digestive symptoms (questionnaire) were measured within one week before and four weeks after initiation of the assigned therapy. The test meal comprised a 200-g pancake containing Tc-99m diethylenetriamine pentaacetic acid.

Results

In the control group, after PegIFN/RBV initiation, a significant increase was observed in the total T1/2 (before: 84.0 ± 22.1 min versus after: 100.8 ± 28.9 min, P = 0.03), the distal T1/2 (before: 95.3 ± 32.2 min versus after: 115.3 ± 41.4 min, P = 0.03), and digestive symptom score (before: 3.2 ± 1.4 versus after: 8.1 ± 4.8, P = 0.02); proximal T1/2 change was not significant. In the mosapride group, no significant delays were observed in the total, proximal, and distal T1/2 values; the change in symptom scores was not significant.

Conclusions

Mosapride improved total and distal gastric motility in IFN-induced gastroparesis, and consequently relieved symptoms.

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Abbreviations

PegIFN:

Pegylated interferon

RBV:

Ribavirin

T1/2:

Half-time of gastric emptying

HCV:

Hepatitis C virus

CHC:

Chronic hepatitis C

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Acknowledgments

The authors wish to thank the staff of the Departments of Hepatology and Nuclear Medicine of Osaka City University Hospital for providing their valuable assistance and gamma camera time during this study.

Conflict of interest

The authors disclose no conflicts.

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Authors and Affiliations

  1. Department of Hepatology, Graduate School of Medicine, Osaka City University, 1-4-3 Asahimachi, Abenoku, Osaka, 545-8585, Japan

    Etsushi Kawamura, Masaru Enomoto, Atsushi Hagihara, Hideki Fujii, Sawako Kobayashi, Shuji Iwai, Hiroyasu Morikawa, Akihiro Tamori & Norifumi Kawada

  2. Department of Nuclear Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan

    Kohei Kotani, Joji Kawabe & Susumu Shiomi

  3. Department of Gastroenterology, Graduate School of Medicine, Osaka City University, Osaka, Japan

    Kazunari Tominaga

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  1. Etsushi Kawamura
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  2. Masaru Enomoto
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Correspondence to Etsushi Kawamura.

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Kawamura, E., Enomoto, M., Kotani, K. et al. Effect of Mosapride Citrate on Gastric Emptying in Interferon-Induced Gastroparesis. Dig Dis Sci 57, 1510–1516 (2012). https://doi.org/10.1007/s10620-012-2085-8

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  • DOI: https://doi.org/10.1007/s10620-012-2085-8

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