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Dr Amelia Pilichiewicz: Preliminary analysis of the
effect of active treatment (STW5, esomeprazole, dual STW5 and
esomeprazole or dual placebo) on symptoms and QOL in patients with
Functional dyspepsia (FD) is a common disorder however no therapy is effective and most treatments provide only minimal gain over placebo. We examined the efficacy of the herbal preparation STW5 (Iberogast®), esomeprazole and placebo in patients with FD. In a double blind, double dummy, randomised study, FD patients (Rome III) received either STW5 (20 drops/TID), esomeprazole (20 mg/daily), dual therapy or double placebo (active-treatment) for 4 wks. Thereafter clinical responders received placebo (placebo treatment) for 2 wks. Ongoing responders were reassessed after 2 wks of no treatment. Symptom occurrence/severity, quality of life (QoL), anxiety and depression were assessed using validated questionnaires. Visceral hypersensitivity was assessed with a nutrient challenge test before and after the 4 wks of active treatment. Blinded data was divided into non- responder and responder groups. Ninety-two FD patients (57F; 49±2 years) have completed the study. Sixty-eight (74%) were responders to active treatment. Of 68 responders, 25 (37%) relapsed during placebo treatment, 23 (34%) relapsed on visible treatment cessation and 20 (29%) continued with sufficient control of symptoms after 2 wks of no treatment. There were no baseline differences between non responders and responders in their initial symptom occurrence/severity, QoL, anxiety or depression. After active treatment symptom occurrence/severity decreased and QoL improved (P<0.01) in responders when compared with non-responders. Anxiety, depression and volume consumed during the nutrient challenge test were not different after active treatment between the non-responders and responders. Thus far 74% of FD patients respond symptomatically to active treatment and report an improved QoL. However the treatment and placebo withdrawal relapse rates are also high. Baseline patient characteristics thus far have not been shown to predict response.
Dr David Camfield: Plant-based psychotropics for anxiety disorders
More info coming soon...