Comparative Efficacy of Various Pharmacological Interventions in the Treatment of Functional Dyspepsia: A Network Meta-Analysis

Abstract

Background and Aim

Patients with functional dyspepsia often select different pharmacological treatments. We aimed to compare and rank the efficacy of different pharmacological interventions in treating functional dyspepsia.

Methods

We searched EMBASE, PubMed, Cochrane, Web of Science and MEDLINE from the date of database inception to March 28, 2019. A random-effects model was selected to conduct traditional meta-analysis to directly examine the efficacy of different pharmacological interventions. The consistency model was selected to conduct a network meta-analysis to evaluate the relative effects and rank probability of different pharmacological interventions.

Results

We included 58 trials (15,629 participants and 21 pharmacological treatments). Network meta-analysis showed that cisapride, domperidone, itopride, and levosulpiride were better than placebo, especially in short term (< 4 weeks). And levosulpiride was significantly more effective than 15 other drugs and placebo (ORs ranging between 0.05 and 0.15). Cisapride was significantly more effective than lansoprazole (OR 0.30, 95% CrI 0.09–0.99) and tegaserod (OR 0.26, 95% CrI 0.07–0.98). The rank probability showed that levosulpiride was most likely to be rank 1 (77%), cinitapride rank 2 (17%), and cisapride rank 3 (23%).

Conclusions

Our study confirmed the effectiveness of several pharmacological treatments for ameliorating functional dyspepsia. Furthermore, levosulpiride relatively ranked the best in managing FD. Physicians should be encouraged to apply promising pharmacological interventions (e.g., levosulpiride and cisapride). However, the results should be interpreted with caution due to small study effects.

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Acknowledgments

This study was supported by the National Natural Science Foundation of China (Nos. 81571325 and 81401117).

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Liang Liang and Gaohua Wang designed the study; Jia Yu, and Ling Xiao collected and interpreted the study data. All authors critically revised the manuscript and approved the final version of the article, including the authorship list.

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Correspondence to Gaohua Wang.

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Liang, L., Yu, J., Xiao, L. et al. Comparative Efficacy of Various Pharmacological Interventions in the Treatment of Functional Dyspepsia: A Network Meta-Analysis. Dig Dis Sci (2021). https://doi.org/10.1007/s10620-021-06846-1

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Keywords

  • Pharmacological interventions
  • Network meta-analysis
  • Functional dyspepsia
  • Efficacy
  • Levosulpiride