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The effect of motilin agonist ABT-229 on gastro-oesophageal reflux, oesophageal motility and lower oesophageal sphincter characteristics in GERD patients.

Abstract

BACKGROUND

ABT-229, a motilin agonist without antibacterial activity, has been shown to enhance both lower oesophageal sphincter pressure in cats and gastric emptying in humans.

AIM

To investigate the effect of oral treatment with ABT-229 10 mg b.d., ABT-229 5 mg b. d. and cisapride 10 mg q.d.s. on gastro-oesophageal reflux, lower oesophageal sphincter pressure, transient lower oesophageal sphincter relaxations and symptoms in GERD patients.

METHODS

Twenty-four GERD patients completed the study. A randomized, double-blind, placebo-controlled, three-period incomplete crossover design was used with three dosing periods of 7 days. All patients received ABT-229 10 mg b.d. and placebo during two of the three periods. In the remaining period 12 patients were given ABT-229 5 mg b.d. and 12 received cisapride 10 mg q.d.s. Ambulatory 24 h recordings of oesophageal pH and pharyngeal, oesophageal, lower oesophageal sphincter and gastric pressures were performed on day 7 using an assembly incorporating a Dent sleeve connected to a portable water-perfused manometric system.

RESULTS

Oesophageal acid exposure was not affected by ABT-229 or cisapride, but the incidence of reflux episodes was reduced by cisapride. None of the drugs affected oesophageal motility, lower oesophageal sphincter pressure or the incidence of transient lower oesophageal sphincter relaxations. Both ABT-229 10 mg b.d. and cisapride reduced the severity of daytime heartburn.

CONCLUSION

The value of ABT-229 in the treatment of GERD appears to be limited.

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  • Authors+Show Affiliations

    ,

    Gastrointestinal Research Unit, Department of Gastroenterology and Surgery, University Medical Center Utrecht, the Netherlands. m.herwaarden@digd.a2u.nl

    , , ,

    Source

    MeSH

    Adult
    Cisapride
    Cross-Over Studies
    Double-Blind Method
    Erythromycin
    Esophagus
    Female
    Gastroesophageal Reflux
    Gastrointestinal Agents
    Humans
    Hydrogen-Ion Concentration
    Male
    Manometry
    Middle Aged
    Motilin

    Pub Type(s)

    Clinical Trial
    Journal Article
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    10759625

    Citation

    Van Herwaarden, M A., et al. "The Effect of Motilin Agonist ABT-229 On Gastro-oesophageal Reflux, Oesophageal Motility and Lower Oesophageal Sphincter Characteristics in GERD Patients." Alimentary Pharmacology & Therapeutics, vol. 14, no. 4, 2000, pp. 453-62.
    Van Herwaarden MA, Samsom M, Van Nispen CH, et al. The effect of motilin agonist ABT-229 on gastro-oesophageal reflux, oesophageal motility and lower oesophageal sphincter characteristics in GERD patients. Aliment Pharmacol Ther. 2000;14(4):453-62.
    Van Herwaarden, M. A., Samsom, M., Van Nispen, C. H., Verlinden, M., & Smout, A. J. (2000). The effect of motilin agonist ABT-229 on gastro-oesophageal reflux, oesophageal motility and lower oesophageal sphincter characteristics in GERD patients. Alimentary Pharmacology & Therapeutics, 14(4), pp. 453-62.
    Van Herwaarden MA, et al. The Effect of Motilin Agonist ABT-229 On Gastro-oesophageal Reflux, Oesophageal Motility and Lower Oesophageal Sphincter Characteristics in GERD Patients. Aliment Pharmacol Ther. 2000;14(4):453-62. PubMed PMID: 10759625.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - The effect of motilin agonist ABT-229 on gastro-oesophageal reflux, oesophageal motility and lower oesophageal sphincter characteristics in GERD patients. AU - Van Herwaarden,M A, AU - Samsom,M, AU - Van Nispen,C H, AU - Verlinden,M, AU - Smout,A J, PY - 2000/4/12/pubmed PY - 2000/5/16/medline PY - 2000/4/12/entrez SP - 453 EP - 62 JF - Alimentary pharmacology & therapeutics JO - Aliment. Pharmacol. Ther. VL - 14 IS - 4 N2 - BACKGROUND: ABT-229, a motilin agonist without antibacterial activity, has been shown to enhance both lower oesophageal sphincter pressure in cats and gastric emptying in humans. AIM: To investigate the effect of oral treatment with ABT-229 10 mg b.d., ABT-229 5 mg b. d. and cisapride 10 mg q.d.s. on gastro-oesophageal reflux, lower oesophageal sphincter pressure, transient lower oesophageal sphincter relaxations and symptoms in GERD patients. METHODS: Twenty-four GERD patients completed the study. A randomized, double-blind, placebo-controlled, three-period incomplete crossover design was used with three dosing periods of 7 days. All patients received ABT-229 10 mg b.d. and placebo during two of the three periods. In the remaining period 12 patients were given ABT-229 5 mg b.d. and 12 received cisapride 10 mg q.d.s. Ambulatory 24 h recordings of oesophageal pH and pharyngeal, oesophageal, lower oesophageal sphincter and gastric pressures were performed on day 7 using an assembly incorporating a Dent sleeve connected to a portable water-perfused manometric system. RESULTS: Oesophageal acid exposure was not affected by ABT-229 or cisapride, but the incidence of reflux episodes was reduced by cisapride. None of the drugs affected oesophageal motility, lower oesophageal sphincter pressure or the incidence of transient lower oesophageal sphincter relaxations. Both ABT-229 10 mg b.d. and cisapride reduced the severity of daytime heartburn. CONCLUSION: The value of ABT-229 in the treatment of GERD appears to be limited. SN - 0269-2813 UR - https://www.unboundmedicine.com/medline/citation/10759625/The_effect_of_motilin_agonist_ABT_229_on_gastro_oesophageal_reflux_oesophageal_motility_and_lower_oesophageal_sphincter_characteristics_in_GERD_patients_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0269-2813&date=2000&volume=14&issue=4&spage=453 DB - PRIME DP - Unbound Medicine ER -