Updates in Gastroenterology: Acotiamide for Treatment of Functional Dyspepsia

Functional dyspepsia (FD) comprises of two types, the postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS). Acotiamide is a new prokinetic agent that acts by increased release of acetylcholine and is used in the treatment of FD-postprandial distress syndrome (FD-PDS). The drug initially launched in Japan is the world’s first approved treatment for FD. It exerts its activity via muscarinic receptor inhibition, which enhances acetylcholine (ACh) release, and via inhibition of acetylcholinesterase (AChE) activity in the stomach. It increases the availability of ACh on postsynaptic receptors in the enteric nervous system. The gastroprokinetic activity of acotiamide does not cause prolongation of the QT interval. Long-term studies of 48 weeks have shown a favorable clinical course with acotiamide in FD.