DOI QR코드

DOI QR Code

기능성 소화불량증 치료제의 임상시험 평가 가이드라인 권고안

Guideline Recommendation for Endpoints Used in Clinical Trials for Functional Dyspepsia

  • 이한희 (가톨릭대학교 의과대학 소화기내과학교실) ;
  • 정혜경 (이화여자대학교 의과대학 소화기내과학교실) ;
  • 최명규 (가톨릭대학교 의과대학 소화기내과학교실)
  • Lee, Han Hee (Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Jung, Hye-Kyung (Division of Gastroenterology, Department of Internal Medicine, Ewha Womans University School of Medicine) ;
  • Choi, Myung-Gyu (Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea)
  • 투고 : 2018.09.03
  • 심사 : 2018.10.16
  • 발행 : 2018.10.31

초록

Functional dyspepsia is a disease, in which there is no organic lesion but chronic and repetitive postprandial fullness, early satiation, epigastric pain, and epigastric burning. Functional dyspepsia is not life-threatening but its symptoms are relapsing and remitting and persist over a lifetime, limiting the social life and reducing the quality of life. Therefore, the treatment for acute relapsing period may help improve the short-term symptoms. Continuous medication may be needed to improve the long-term symptoms. Research designs to demonstrate the short-term efficacy of therapeutic agents may differ from clinical trials to demonstrate long-term efficacy. There are many difficulties in clinical trial design, implementation, and screening because there are no international standards of clinical trials for functional dyspepsia. The purpose of this guideline recommendation is to develop a standard for clinical trials, such as clinical trial subjects and evaluation methods, in the development of therapeutic agents for functional dyspepsia. The ultimate aim is to enhance the safety and efficacy of therapeutic agents for functional dyspepsia and promote the development of new therapeutic agents.

키워드

참고문헌

  1. Stanghellini V, Chan FK, Hasler WL, et al. Gastroduodenal disorders. Gastroenterology 2016;150:1380-1392. https://doi.org/10.1053/j.gastro.2016.02.011
  2. Moayyedi PM, Lacy BE, Andrews CN, Enns RA, Howden CW, Vakil N. ACG and CAG clinical guideline: management of dyspepsia. Am J Gastroenterol 2017;112:988-1013. https://doi.org/10.1038/ajg.2017.154
  3. Pinto-Sanchez MI, Yuan Y, Bercik P, Moayyedi P. Proton pump inhibitors for functional dyspepsia. Cochrane Database Syst Rev 2017;3:CD011194.
  4. Ford AC, Luthra P, Tack J, Boeckxstaens GE, Moayyedi P, Talley NJ. Efficacy of psychotropic drugs in functional dyspepsia: systematic review and meta-analysis. Gut 2017;66:411-420. https://doi.org/10.1136/gutjnl-2015-310721
  5. Irvine EJ, Tack J, Crowell MD, et al. Design of treatment trials for functional gastrointestinal disorders. Gastroenterology 2016;150:1469-1480.e1. https://doi.org/10.1053/j.gastro.2016.02.010
  6. Vakil NB, Howden CW, Moayyedi P, Tack J. White paper AGA: functional dyspepsia. Clin Gastroenterol Hepatol 2017;15:1191-1194. https://doi.org/10.1016/j.cgh.2017.05.013
  7. Park JM, Choi MG, Cho YK, et al. Functional gastrointestinal disorders diagnosed by Rome III questionnaire in Korea. J Neurogastroenterol Motil 2011;17:279-286. https://doi.org/10.5056/jnm.2011.17.3.279
  8. Vakil N, van Zanten SV, Chang L, et al. Comprehension and awareness of symptoms in women with dyspepsia. Aliment Pharmacol Ther 2005;22:1147-1155. https://doi.org/10.1111/j.1365-2036.2005.02699.x
  9. Howden CW, Vakil NB. American gastroenterological association drug development conferences: a model for future collaborations. Clin Gastroenterol Hepatol 2017;15:1195-1196. https://doi.org/10.1016/j.cgh.2017.02.035
  10. Guidance for Industry. Patient-Reported Outcomes Measures: Use in Medical Product Development to Support Labeling Claims. [Internet]. Rockville: US Department of Health and Human Services Food and Drug Administration, Center for Drug Evaluation and Research (CDER), Center for Biologics Evaluation and Research (CBER), Center for Devices and Radiological Health (CDRH); 2009 [updated 2009 Dec; cited 2018 Sep 3]. Available from: http://www.fda.gov/downloads/Drugs/Guidances/UCM193282.pdf
  11. Guidance for Industry: Irritable Bowel Syndrome - Clinical Evaluation of Drugs for Treatment. [Internet]. Rockville: US Department of Health and Human Services Food and Drug Administration, Center for Drug Evaluation and Research (CDER); 2012 [updated 2012 May; cited 2018 Sep 3]. Available from: http://www.fda.gov/downloads/Drugs/Guidances/UCM205269.pdf
  12. Drossman DA, Chang L, Chey WD, Kellow J, Tack J, Whitehead WE. Rome IV functional gastrointestinal disorders: disorders of gut-brain interaction. 4th ed. Raleigh: Rome Foundation, Inc., 2016.
  13. Ang D, Talley NJ, Simren M, Janssen P, Boeckxstaens G, Tack J. Review article: endpoints used in functional dyspepsia drug therapy trials. Aliment Pharmacol Ther 2011;33:634-649. https://doi.org/10.1111/j.1365-2036.2010.04566.x
  14. Choi MG, Rhee PL, Park H, et al. Randomized, controlled, multi-center trial: comparing the safety and efficacy of DA-9701 and itopride hydrochloride in patients with functional dyspepsia. J Neurogastroenterol Motil 2015;21:414-422. https://doi.org/10.5056/jnm14117
  15. Matsueda K, Hongo M, Tack J, Saito Y, Kato H. A placebo-controlled trial of acotiamide for meal-related symptoms of functional dyspepsia. Gut 2012;61:821-828. https://doi.org/10.1136/gutjnl-2011-301454
  16. Corsetti M, Tack J. FDA and EMA end points: which outcome end points should we use in clinical trials in patients with irritable bowel syndrome? Neurogastroenterol Motil 2013;25:453-457. https://doi.org/10.1111/nmo.12151
  17. Guideline on the evaluation of medicinal products for the treatment of irritable bowel syndrome. [Internet]. London: European Medicines Agency; 2013 [updated 2014 Sep 25; cited 2018 Sep 3]. Available from: https://www.ema.europa.eu/documents/scientific-guideline/guideline-evaluation-medicinal-productstreatment-irritable-bowel-syndrome-revision-1_en.pdf
  18. Carbone F, Vandenberghe A, Holvoet L, et al. Validation of the leuven postprandial distress scale, a questionnaire for symptom assessment in the functional dyspepsia/postprandial distress syndrome. Aliment Pharmacol Ther 2016;44:989-1001. https://doi.org/10.1111/apt.13753
  19. Tack J, Carbone F, Holvoet L, Vanheel H, Vanuytsel T, Vandenberghe A. The use of pictograms improves symptom evaluation by patients with functional dyspepsia. Aliment Pharmacol Ther 2014;40:523-530.
  20. Cho YK, Choi MG, Kim SH, et al. The effect of mosapride on quality of life in functional dyspepsia. Korean J Gastroenterol 2004;43:160-167.

피인용 문헌

  1. Functional Dyspepsia vol.73, pp.2, 2018, https://doi.org/10.4166/kjg.2019.73.2.77
  2. The Efficacy and Safety of GCWB104 ( Flos Lonicera Extract) in Functional Dyspepsia: A Single-Center, Randomized, Double-Blind, Placebo-Controlled Study vol.14, pp.1, 2018, https://doi.org/10.5009/gnl19283