Efficacy and Safety of DWJ1252 Compared With Gasmotin Treatment: Once Met 3 Times Tablets

摘要

Previously, functional dyspepsia (FD) was divided into 3 categories of reflux-like, ulcer-like, and dysmotility-like FD.1 A paradigm shift has occurred in FD, subdividing FD into epigastric pain syndrome and post-prandial discomfort.2 According to the American and Canadian guidelines of FD management, in Helicobactyer pylori-positive patients, H. pylori eradication therapy should be considered the first-line treatment.3 However, considering the high prevalence of H. pylori in Korea, H. pylori eradication therapy is recommended when proton pump inhibitors (PPIs) and prokinetics are not effective.4 Meta-analysis shows significant but modest efficacy of H. pylori eradication on long-term resolution of FD symptoms.5H. pylori eradication therapy can be applied in cases where PPIs and prokinetics are not effective, or in young patients with chronic dyspeptic symptoms in Korea. In contrast, in patients with FD who do not respond to PPIs, H. pylori eradication therapy, or tricyclic antidepressant therapy, treatment with prokinetics should be tried according to the American and Canadian guidelines. Where does this difference come from? Postprandial fullness is the most troublesome symptom in FD patients, aggravated by a meal.6 Therefore, prokinetics, improving gastric emptying, relaxing the fundus, and increasing gastric accommodation, may have a role in the treatment of FD.7 However, most studies on prokinetics had significant and unexplained heterogeneity. Small studies showed positive results but larger trials could not demonstrate significant efficacy.3