Mosapride treatment for functional dyspepsia: A meta-analysis

Background and AimThe aim of this study was to assess the therapeutic effect of mosapride in patients with functional dyspepsia (FD). MethodsRandomized controlled trials (RCTs) of mosapride for the treatment of FD performed between 2002 and 2013 were identified from databases. Symptom response rates were extracted and analyzed using risk ratios (RRs). A random effect model was applied based on Higgins I-2 tests. Publication bias was evaluated using a funnel plot, Egger's test, trim and fill, and the rank correlation test. ResultsIn total, 13 RCTs, which included 1091 mosapride-treated patients and 1129 control patients (on placebo or other drugs), were identified and analyzed. Overall, mosapride showed an RR of 0.999 (95% confidence interval [CI]: 0.869-1.150, P=0.992) for improving global efficacy or symptom-based scores. In a sensitivity analysis of the high-quality RCTs, mosapride showed an RR of 1.114 (95% CI: 1.011-1.227, P=0.029). However, in the studies using the Rome III criteria for the diagnosis of FD, mosapride showed an RR of 0.906 (95% CI: 0.807-1.016, P=0.092). In the studies having funding source, mosapride showed an RR of 1.131 (95% CI: 1.028-1.244, P=0.012), whereas an RR of 0.966 (95% CI: 0.896-1.042, P=0.367) was observed in the studies without funding source. Publication bias was not detected. ConclusionIn this analysis, we could not find a significant effect of mosapride on FD. Inconsistent diagnostic criteria for FD and different assessment outcomes are causes of heterogeneity. Further studies using common validated outcomes or questionnaires and high-quality RCTs will elucidate the real effect of this medication on FD.