5 research outputs found
Tu1411 Beneficial Effect of Long-Term Buspirone Administration on LES Function and on Esophageal Symptoms in Patients With Systemic Sclerosis
Beneficial effect of the 5-HT1A receptor agonist buspirone on esophageal dysfunction associated with systemic sclerosis: A pilot study
Background: Esophageal involvement in systemic sclerosis (SSc) carries
significant morbidity and is empirically managed with domperidone,
albeit with questionable efficacy. The oral 5-HT1A receptor agonist
buspirone may enhance esophageal peristalsis and lower esophageal
sphincter (LES) function in healthy volunteers.
Aim: We aimed to test the hypothesis that buspirone may exert a
beneficial acute effect on esophageal motor dysfunction in symptomatic
patients with SSc.
Methods: Twenty consecutive patients with SSc reporting esophageal
symptoms underwent high-resolution manometry before and 30 minutes after
administration of buspirone (10 mg). Ten other patients received
domperidone (10 mg) and served as control group. Changes in LES resting
and residual pressure, amplitude, duration, and velocity of distal
esophageal body contractions were examined.
Results: Esophageal hypomotility and hypotensive LES was found in 63%
and 67% of patients, respectively. Demographic and clinical
characteristics, including baseline manometric parameters, were
comparable between groups. Resting pressure of LES increased after
buspirone from 9.42 +/- 2.6 to 11.53 +/- 3.4 mmHg (p = 0.0002 by paired
t-test), but not after domperidone; a trend for increase of amplitude of
contractions was also observed after buspirone (p = 0.09). Comparison of
the individual changes revealed that buspirone was superior to
domperidone in enhancing LES pressure (+2.11 +/- 2.0 versus - 0.45 +/-
2.3 mmHg, p = 0.006). No significant effects of either drug were noted
on other examined parameters of esophageal function.
Conclusion: The beneficial acute effect of buspirone on impaired LES
function associated with SSc suggests a role of 5-HT1A receptor-mediated
interactions in these patients. Prospective studies to examine whether
buspirone is of long-term therapeutic value for SSc-associated
esophageal disease are warranted