Effect of Mosapride Citrate on Gastric Emptying in Interferon-Induced Gastroparesis

Gastroparesis, a gastrointestinal autonomic neuropathy, is a common adverse reaction in chronic hepatitis C (CHC) patients receiving interferon therapy. Current therapeutic options are limited. We evaluated the efficacy of mosapride for IFN-induced gastroparesis. Twenty-four consecutive CHC patients were randomly assigned to either the control group, which received pegylated interferon alpha-2b at 1.5 mu g/kg/week and ribavirin at 600-1,000 mg/day, depending on body weight (PegIFN/RBV), or the mosapride group, which received PegIFN/RBV plus mosapride at 15 mg/person/day. The solid-phase gastric emptying half-times (T1/2) of the total, proximal, and distal stomach (scintigraphy) and digestive symptoms (questionnaire) were measured within one week before and four weeks after initiation of the assigned therapy. The test meal comprised a 200-g pancake containing Tc-99m diethylenetriamine pentaacetic acid. In the control group, after PegIFN/RBV initiation, a significant increase was observed in the total T1/2 (before: 84.0 +/- A 22.1 min versus after: 100.8 +/- A 28.9 min, P = 0.03), the distal T1/2 (before: 95.3 +/- A 32.2 min versus after: 115.3 +/- A 41.4 min, P = 0.03), and digestive symptom score (before: 3.2 +/- A 1.4 versus after: 8.1 +/- A 4.8, P = 0.02); proximal T1/2 change was not significant. In the mosapride group, no significant delays were observed in the total, proximal, and distal T1/2 values; the change in symptom scores was not significant. Mosapride improved total and distal gastric motility in IFN-induced gastroparesis, and consequently relieved symptoms.