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Gabapentin helps improve dyspeptic symptoms

15 May 2018

Treatment with gabapentin appears to yield substantial improvements in dyspeptic symptoms in patients with functional dyspepsia, according to the results of an open-label study.

The study included 110 functional dyspepsia patients without concurrent gastric emptying delay. All patients completed a baseline Patient Assessment of Gastrointestinal Disorders-Symptom Severity Index (PAGI-SYM) and were started on gabapentin by their physicians. The primary endpoint was change in total PAGI-SYM score between initial and subsequent visits.

Only 62 patients completed pregabapentin and postgabapentin surveys. Mean PAGI-SYM score decreased by 0.44 (p<0.0001), and there were significant improvements in all subscales including upper abdominal pain, lower abdominal pain and postprandial fullness, with the exception of bloating.

On multivariable linear regression analysis, pretreatment PAGI-SYM score significantly predicted total PAGI-SYM score change. Specifically, increasing pretreatment PAGI-SYM score correlated with a significant increase in the difference between pretreatment and post-treatment scores (p=0.01).

When the minimum significant PAGI-SYM score change threshold was used, ≥50 percent of the cohort had significant improvements in overall, postprandial fullness and upper abdominal pain subscores.

Gabapentin was well tolerated overall, with a low discontinuation rate and a low rate of adverse events. Of the seven patients (11.3 percent) who discontinued gabapentin, five (71.4 percent) did so due to side effects.

The present data show that gabapentin may represent another option in the armamentarium against a heterogenous disease with diverse pathophysiology and symptom burden, researchers said. However, additional studies are needed to further evaluate the impact of the drug on neuromodulation, as well as to elucidate its role in the treatment algorithm for dyspepsia.

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