Authors: Kahrilas, P. J.¹; Quigley, E. M. M.²; Castell, D. O.³; Spechler, S. J.⁴

Source: Alimentary Pharmacology & Therapeutics, Volume 14, Number 11, November 2000 , pp. 1503-1509(7)

Publisher: Wiley-Blackwell

Abstract:

Background: 

Tegaserod (HTF 919), a 5-HT₄ receptor partial agonist, has prokinetic effects that might be useful in decreasing acid reflux in gastro-oesophageal reflux disease (GERD). Methods: 

To investigate the potential clinical utility of tegaserod in GERD, a five-period crossover study (balanced Latin square) was designed to evaluate the efficacy of 4 b.d. doses of tegaserod vs. placebo. Four-hour manometry (1 h fasting and 3 h postprandial) with continuous recording of lower oesophageal sphincter pressure and distal oesophageal pH, was performed at the end of each 2-week treatment period in 19 patients with mild-to-moderate GERD. Recordings were scored for mean lower oesophageal sphincter pressure, number of transient lower oesophageal sphincter relaxations, and distal oesophageal acid exposure. Results: 

Tegaserod (1 mg/day and 4 mg/day) caused a more than 50% decrease in acid exposure in the postprandial period in patients with abnormal acid exposure, although only the 1 mg/day tegaserod treatment elicited statistically significant decreasing (P < 0.05) for the entire treatment group (percentage time for which pH < 4: placebo=13%; 1 mg/day dose=5%; 4 mg/day dose=8%). A decreased number of reflux episodes was demonstrated with both the 1 mg/day and 4 mg/day tegaserod doses. There was no apparent effect on mean lower oesophageal sphincter pressure, whilst transient lower oesophageal sphincter relaxations frequency decreased in the 1-2.5 h post-dose. Conclusions: 

Tegaserod in a dose of 1 mg/day causes a significant decrease in postprandial oesophageal acid exposure. The reduction in oesophageal acid exposure with tegaserod treatment may result from enhanced oesophageal acid clearance, improved gastric emptying, and/or reduced transient lower oesophageal sphincter relaxations.

Document Type: Research article

DOI: http://dx.doi.org/10.1046/j.1365-2036.2000.00854.x

Affiliations: 1: Northwestern University Medical School, Chicago, Illinois, USA 2: University of Nebraska Medical Center, Omaha, Nebraska, USA 3: Graduate Hospital, Philadelphia, Pennsylvania, USA 4: Dallas VA Medical Center, Dallas, Texas, USA

Publication date: 2000-11-01

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