Efficacy And Safety Of Itopride Therapy Compared With Domperidone Therapy For Functional Dyspepsia:A Meta-Analysis

Objective:To conduct a Meta-analysis to evaluate the efficacy and safety of itopride therapy compared with domperidone therapy for functional dyspepsia (FD).Methods:Use itopride、domperidone、functional dyspepsia as keywords, search PubMed、Cochrane Library、Embase、Tsinghua Tongfang database (CNKI、Chinese Biomedical Literature Database (CBM)、VIP database (VIP) and Articles Database (WANGFANG), which were published before February 2015, were searched for randomized controlled trials (RCTs) about itopride compared with domperidone treatment for functional dyspepsia. Use Jadad modified method judge methodological quality of RCTs by two independent appraisers. The primary end point was clinical remission, gastric emptying efficacy, total efficacy and total adverse events.The extracted data were analyzed with Revman 5.2 provided by Cochrane.Results:A total of 13 studies scored 4 points or more by Jadad modified method involving 2002 patients included in the Meta-analysis. The patients were randomly divided into treatment group given by itopride(1016 cases)and control group given by domperidone(986 cases). The results showed that in functional dyspepsia treatment, the itopride therapy was more effective than domperidone therapy on total efficacy(OR=3.26,95%CI 1.91 to 5.57, P<0.0001)、early satiety efficacy(OR=2.12,95%CI 1.14 to 3.95, P=0.02)and bloating efficacy(OR=1.51, 95%CI 1.14 to 2.02, P=0.005); No significant difference observed between itopride therapy and domperidone therapy on nausea efficacy(OR=1.74,95%CI 0.71to 4.28, P=0.22)、belching efficacy(OR=1.45,95%CI 0.45 to 2.46,P=0.17)、 anorexia efficacy(OR=1.33,95%CI 0.37 to 4.80,P=0.66)、epigastric pain efficacy(OR=1.34,95%CI 0.82 to 2.20, P=0.25)、acid reflux efficacy(OR=1.45, 95%CI 0.60 to 3.46, P=0.41)、vomiting efficacy(OR=0.81,95%CI 0.15 to 4.31, P=0.81). heartburn(OR=0.91,95%CI 0.41 to 2.02,P=0.82)、epigastric discomfort efficacy(OR=0.99,95%CI 0.65 to 1.52, P=0.98) and gastric emptying efficacy(OR=1.30,95%CI 0.48 to 3.49, P=0.61);The itopride therapy in functional dyspepsia treatment was more safe than domperidone therapy (OR=0.66,95%CI 0.46 to 0.93, P=0.02).Conclusions:Totality, patients with functional dyspepsia who were treated with itopride is more likely to have better effectiveness on total efficacy and is more safer than domperidone therapy. For each symptom improvement rate and gastric emptying efficacy, patients with functional dyspepsia who were treated with itopride is more likely to have better effectiveness on early satiety efficacy and bloating efficacy, but they have no significant difference on other symptom and gastric emptying.