Current status and prospects of using the prokinetic acotiamide in gastroenterology: A review

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Abstract

Acotiamide is a prokinetic with a novel mechanism of action – an antagonist of muscarinic M1 and M2 receptors and an acetylcholinesterase inhibitor. Acetylcholine is the central mediator of the tone of the muscular components of the gastrointestinal tract, increasing its motor activity. Blockade of presynaptic M1 and M2 receptors neutralizes the inhibitory effect of the feedback mechanism on the acetylcholine synthesis, while inhibition of acetylcholinesterase in the synaptic cleft reduces the acetylcholine degradation. Currently, the clinical efficacy of acotiamide in the population of patients with functional dyspepsia is demonstrated in more than 10 clinical studies in different regions of the world, demonstrating a reduction of the symptoms of the disease during treatment with this agent and an improvement in the quality of life of patients. In addition, the combination of acotiamide with proton pump inhibitors optimizes the management of patients with gastroesophageal reflux disease.

About the authors

Igor V. Maev

Yevdokimov Moscow State University of Medicine and Dentistry

Email: dna-mit8@mail.ru
ORCID iD: 0000-0001-6114-564X

акад. РАН, д-р мед. наук, проф., зав. каф. пропедевтики внутренних болезней и гастроэнтерологии

Russian Federation, Moscow

Dmitry N. Andreev

Yevdokimov Moscow State University of Medicine and Dentistry

Author for correspondence.
Email: dna-mit8@mail.ru
ORCID iD: 0000-0002-4007-7112

канд. мед. наук, доц. каф. пропедевтики внутренних болезней и гастроэнтерологии

Russian Federation, Moscow

Andrew V. Zaborovsky

Yevdokimov Moscow State University of Medicine and Dentistry

Email: dna-mit8@mail.ru
ORCID iD: 0000-0002-7923-9916

д-р мед. наук, проф., зав. каф. фармакологии

Russian Federation, Moscow

Elena G. Lobanova

Yevdokimov Moscow State University of Medicine and Dentistry

Email: dna-mit8@mail.ru
ORCID iD: 0000-0002-3426-1853

д-р мед. наук, проф. каф. фармакологии

Russian Federation, Moscow

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2. Fig. 1. Schematic model of interneuronal connections involved in the regulation of intermuscular plexus motor neuron function.

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3. Fig. 2. Mechanism of action of acotiamide.

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