Takeuchi T, et al. – The clinicians aimed to compare the efficacy of acotiamide in combination with a standard dose of rabeprazole for gastroesophageal reflux disease (GERD) and functional dyspepsia (FD) with that of a double dose of rabeprazole. In patients with overlap between GERD and FD experiencing heartburn and epigastric fullness symptoms after standard–dose proton pump inhibitor (PPI) for ≥8 weeks, acotiamide 300 mg/day in combination with rabeprazole 10 mg/day or rabeprazole 20 mg/day relieved symptoms, and the efficacies did not differ between the two treatments. For persistent symptoms, the combination therapy could be an alternative option in these patients.

• The clinicians randomized patients with overlap between GERD and FD experiencing heartburn and epigastric fullness symptoms after standard-dose proton pump inhibitor (PPI) for ≥8 weeks into 2 groups, and received either acotiamide 300 mg/day + rabeprazole 10 mg/day or rabeprazole 20 mg/day for 4 weeks.
• They evaluated efficacy by reductions in symptom scores using the Izumo scale questionnaire and modified F-scale questionnaire.

• With no significant difference between the two groups, 3 upper gastrointestinal symptoms (heartburn, epigastralgia, and epigastric fullness) were reduced by ≥50% in 40.8% and 46.9% of patients in the combination and PPI double-dose groups, respectively, as the primary endpoint.
• For the modified F-scale questionnaire, essentially similar results were obtained.
• There were no serious adverse events.