THERAPY OF GERD AND FD OVERLAP WITH SYMPTOMS AFTER USUAL-DOSE PPI: ACOTIAMIDE PLUS USUAL-DOSE PPI VS. DOUBLE-DOSE PPI

Background and AimGastroesophageal reflux disease (GERD) and functional dyspepsia (FD) often coexist or overlap. In this study, the efficacy of acotiamide in combination with a standard dose of rabeprazole for GERD and FD was compared with that of a double dose of rabeprazole. MethodsPatients with overlap between GERD and FD experiencing heartburn and epigastric fullness symptoms after standard-dose proton pump inhibitor (PPI) for 8weeks were randomized into two groups and received either acotiamide 300mg/day + rabeprazole 10mg/day or rabeprazole 20mg/day for 4weeks. Efficacy was assessed by reductions in symptom scores using the Izumo scale questionnaire and modified F-scale questionnaire. ResultsAs the primary endpoint, three upper gastrointestinal symptoms (heartburn, epigastralgia, and epigastric fullness) were reduced by 50% in 40.8% and 46.9% of patients in the combination and PPI double-dose groups, respectively, with no significant difference between the two groups. Essentially similar results were obtained for the modified F-scale questionnaire. No serious adverse events were noted. ConclusionsAcotiamide 300mg/day in combination with rabeprazole 10mg/day or rabeprazole 20mg/day relieved symptoms in patients with overlap between GERD and FD experiencing heartburn and epigastric fullness symptoms after standard-dose PPI for 8weeks, and the efficacies did not differ between the two treatments. The combination therapy may be an alternative option for persistent symptoms in these patients.