EYcacy and safety of the peripheral kappa agonist fedotozine versus placebo in the treatment of functional dyspepsia

Background—Peripheral kappa receptor agonists may provide a new therapeutic approach for the treatment of functional dyspepsia. Aims—To evaluate, in a large multicentre trial, the use of the kappa receptor agonist fedotozine to improve symptoms associated with functional dyspepsia. Methods—Two or more of the following persistent symptoms were required for inclusion: epigastric pain, early satiety, epigastric fullness or distension, nausea, vomiting, and a feeling of slow digestion. On completing a two week placebo washout, 271 patients were randomised into two groups to receive 30 mg fedotozine three times daily or placebo for six weeks under double blind conditions. Results—The improvement in the overall intensity of dyspeptic symptoms (main eYcacy criterion) was significantly more pronounced in the fedotozine group (p=0.002) compared with placebo, as was epigastric pain (p=0.004) and nausea (p=0.01); the improvement in postprandial fullness was nearly significant (p=0.052). Inability to finish a meal and slow digestion were unaVected. The patient global score, the average of the five individual symptoms, was notably ameliorated with fedotozine (p=0.021). The safety of fedotozine was excellent. Conclusions—Fedotozine at 30 mg three times daily is safe and more eVective than placebo for the relief of key symptoms associated with functional dyspepsia. (Gut 1997; 41: 664–668)