Long-term safety and efficacy of acotiamide in functional dyspepsia (postprandial distress syndrome)results from the European phase 3 open-label safety trial

BackgroundsAcotiamide is a novel acetylcholinesterase inhibitor for treatment of postprandial distress syndrome (PDS) symptoms of functional dyspepsia (FD). This European phase 3 open-label safety trial has been conducted to evaluate the long-term safety of acotiamide and explore the efficacy of acotiamide on PDS symptoms using the validated LPDS, quality of life using SF-36 and SF-NDI, and work productivity using WPAI. MethodsFD-PDS patients (defined by ROME III criteria) aged 18years with active PDS symptoms and without predominant overlapping symptoms of epigastric pain syndrome and related disorders were enrolled to receive 100mg acotiamide three times daily for 1year. Patients' safety profile and efficacy of acotiamide were monitored. Key ResultsThe majority of patients (81.6%) maintained exposure to acotiamide for >50weeks, with a mean duration of 320.3days. No specific clinically significant safety concerns have been shown, with no deaths, treatment-related severe/serious adverse events, or any clinically significant laboratory test results. Although being an open-label trial, acotiamide showed a change in severity larger than the minimum clinically important difference at weeks 1 and 2 for postprandial fullness and early satiation (meal-related symptoms), and showed improvement of quality of life and work productivity from the first measurement (at week 12) up to 1year. Conclusions & InferencesThe long-term safety of acotiamide treatment was confirmed. A clinically important change for PDS symptoms, QoL, and work productivity was suggested; however a controlled trial is required to confirm this hypothetic efficacy of acotiamide. (NCT01973790).