Meta-analysis of the effects of prokinetic agents in patients with functional dyspepsia

J Gastroenterol Hepatol. 2007 Mar;22(3):304-10. doi: 10.1111/j.1440-1746.2006.04493.x.


Background: Functional dyspepsia (FD) is often treated with prokinetic agents; however, the efficacy of prokinetic agents in patients with FD has been questioned recently. The aim of this study was to perform a meta-analysis of the effects of prokinetic agents in patients with FD.

Methods: Prokinetic agents, including metoclopramide, domperidone, trimebutine, cisapride, itopride and mosapride, used for treatment of FD between 1951 and 2005 were identified. Twenty-seven studies were selected. Difference in the probability of response between the interventional drug and placebo was used as a summary statistic for the treatment effect. Meta-regression analysis was used to detect sources of heterogeneity.

Results: In total, 1844 subjects were assigned to an experimental arm, and 1591 subjects were assigned to a placebo arm. Publication bias was ruled out by funnel plot and statistical testing (P = 0.975). In the overall analysis, the summary statistic was 0.295 (95% confidence interval: 0.208-0.382, P < 0.001), indicating that the interventional drug has 30% excess probability of producing a response compared with placebo. The most significant source of heterogeneity was the year of publication (P < 0.001).

Conclusion: The data clearly indicate that prokinetic agents are significantly more effective than placebo in the treatment of FD. Although FD is a chronic condition, efficacy was assessed over short periods. Long-term randomized controlled trials are needed to confirm the effect.

Publication types

  • Meta-Analysis

MeSH terms

  • Benzamides / therapeutic use
  • Benzyl Compounds / therapeutic use
  • Cisapride / therapeutic use
  • Domperidone / therapeutic use
  • Dopamine Antagonists / therapeutic use*
  • Dyspepsia / drug therapy*
  • Gastrointestinal Agents / therapeutic use*
  • Humans
  • Metoclopramide / therapeutic use
  • Morpholines / therapeutic use
  • Trimebutine / therapeutic use


  • Benzamides
  • Benzyl Compounds
  • Dopamine Antagonists
  • Gastrointestinal Agents
  • Morpholines
  • Domperidone
  • itopride
  • mosapride
  • Metoclopramide
  • Trimebutine
  • Cisapride