SUNY Downstate Health Sciences University Brooklyn, NY, United States
Bhesh R. Karki, MD1, Dhan B. Shrestha, MD2, Pravash Budhathoki, MD3, Yub Raj Sedhai, MD4, Prarthana Subedi, MBBS5, Manita Khadka, MBBS5, Prabesh Karki, MBBS5 1SUNY Downstate Health Sciences University, Brooklyn, NY; 2Mount Sinai Hospital, Chicago, IL; 3BronxCare Health System, Bronx, NY; 4Virginia Commonwealth University School of Medicine, Richmond, VA; 5Nepalese Army Institute of Health Sciences, Kathmandu, Bagmati, Nepal
Introduction: Functional dyspepsia is a common gastrointestinal condition. Despite extensive treatment, different population studies have shown it to be relapsing and remitting. The novel drug that has come into the picture recently is Acotiamide hydrochloride trihydrate. It is a gastric motility modulator and unlike other prokinetic drugs, it has a low affinity for serotonin receptors (5-HT2, 5-HT3, 5-HT4). Acotiamide exerts prokinetic activity by increasing the release of acetylcholine by antagonism of M1 and M2 muscarinic receptors and inhibition of acetylcholinesterase activity.
Methods: We conducted searches in different electronic databases like PubMed, PubMed Central, Scopus, and Embase using appropriate Boolean operators with no language restriction. Statistical analysis was done using RevMan 5.4 and odds ratio (OR) was used as appropriate.
Results: Three studies were included in quantitative synthesis. Improvement in symptoms of functional dyspepsia after treatment was higher in the treatment group compared to placebo but could not reach statistical significance in random effect model (OR, 1.48; 95% CI, 0.93 to 2.35; n = 1697; I2 = 59%). No significant differences in adverse effects were reported between two groups for raise in serum prolactin (OR 1.02, 95% CI 0.64 to 1.61; n = 1709; I2 = 44%), raise in ALT (OR 1.27, 95% CI 0.70 to 2.33; n = 1709; I2 = 0%), raise in serum bilirubin (OR, 0.98; 95% CI, 0.52 to 1.87; I 2 = 0%).
Discussion: This systematic review and meta-analysis aimed to evaluate the efficacy and also the adverse effects of acotiamide, a promising novel drug in functional dyspepsia. Our results did not show significant improvement in the symptoms as compared to placebo, which could be due to paucity of studies. Additionally, the analysis did not show any significant differences in the reported adverse outcomes like raised serum prolactin, raised ALT, and raised bilirubin, so further larger prospective studies or RCTs are warranted.
Figure: Forest plot showing Improvement in symptoms of functional dyspepsia using random effect model
Bhesh Karki indicated no relevant financial relationships.
Dhan Shrestha indicated no relevant financial relationships.
Pravash Budhathoki indicated no relevant financial relationships.
Yub Raj Sedhai indicated no relevant financial relationships.
Prarthana Subedi indicated no relevant financial relationships.
Manita Khadka indicated no relevant financial relationships.
Prabesh Karki indicated no relevant financial relationships.
Bhesh R. Karki, MD1, Dhan B. Shrestha, MD2, Pravash Budhathoki, MD3, Yub Raj Sedhai, MD4, Prarthana Subedi, MBBS5, Manita Khadka, MBBS5, Prabesh Karki, MBBS5. P1373 - Use of Acotiamide in Functional Dyspepsia: A Systematic Review and Meta-Analysis, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.