THE EFFECT OF MOSAPRIDE, A NOVEL PROKINETIC, ON ACID REFLUX VARIABLESIN PATIENTS WITH GASTROESOPHAGEAL REFLUX DISEASE

Background: Mosapride is a novel prokinetic agent facilitating acetylc holine release from the enteric cholinergic neurones through a selecti ve 5-HT4 receptor agonistic action, It is also active through its main metabolite M1, which is a 5-HT3 antagonist, The importance of motor d ysfunction in the pathogenesis of gastro-oesophageal reflux disease (G ERD) makes it interesting to examine the effect of mosapride on oesoph ageal acid exposure, Methods: The effect of mosapride on oesophageal 2 4-h acid reflux variables was studied in 21 patients with GERD symptom s and a pre-entry total acid exposure time (pH < 4) of more than 5%, A mbulatory pH monitoring was performed after treatment with 40 mg mosap ride citrate or placebo q.d.s. for 2 days in random order, using a dou ble-blind crossover technique, with a washout period of at least 5 day s. Results: Mosapride was significantly more effective than placebo in decreasing the total number of reflux episodes, the total number of r eflux episodes lasting more than 5 min and the total time, as well as the amount of day time, of intra-oesophageal pH below 4. Consequently, mosapride also significantly improved total acid clearance time, Conc lusion: Mosapride 40 mg q.d.s, is effective in decreasing acid reflux in the oesophagus in patients with GERD and therefore has the potentia l to be effective in the treatment of this disease.