Efficacy of Cisapride on Symptoms and Healing of Gastro-Oesophageal Reflux Disease: A Review

Cisapride is a new drug which stimulates gastrointestinal motility via facilitation of acetylcholine release from myenteric nerves. European studies have addressed its clinical efficacy in treating gastro-oesophageal reflux disease in three areas. 1) Symptom relief: Cisapride, usually at a dose of 10 mg t.i.d., was superior to placebo and metoclopramide in relief of daytime and night-time heartburn and regurgitation. 2) Healing oesophagitis: Six studies showed that cisapride 10 mg q.i.d effectively heals oesophagitis over 6-16 weeks. Cisapride was superior to placebo and as effective as H2-antagonists in healing grades I-III oesophagitis. Combination therapy with H2-antagonists may be superior to H2-blocker alone. 3) Paediatric efficacy: Cisapride 1 mg/kg/day was effective in the treatment of infants and children with oesophagitis and pulmonary symptoms related to acid reflux. In conclusion, cisapride offers a promising alternative for the treatment of gastrooesophageal reflux disease without the troubling side effects of existing promotility drugs.