Efficacy of camostat mesilate against dyspepsia associated with non-alcoholic mild pancreatic disease

• Published in: Journal of gastroenterology Vol. 45; no. 3; pp. 335 - 341
• Main Authors: Sai, Jin Kan, Suyama, Masafumi, Kubokawa, Yoshihiro, Matsumura, Yuji, Inami, Koichi, Watanabe, Sumio
• Format: Journal Article
• Language: English
• Published: Japan Japan : Springer Japan 01-03-2010; Springer Japan; Springer; Springer Nature B.V
• Subjects: Abdominal Pain - diagnosis; Abdominal Pain - drug therapy; Abdominal Pain - etiology; Abdominal Surgery; Adult; Aged; Amylases; Biliary Tract; Care and treatment; Colorectal Surgery; Diagnostic imaging; Dyspepsia; Dyspepsia - diagnosis; Dyspepsia - drug therapy; Dyspepsia - etiology; Endosonography - methods; Female; Gabexate - analogs & derivatives; Gabexate - pharmacology; Gastroenterology; Hepatology; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article—Liver; Pain Measurement; Pancreas; Pancreatic Diseases - diagnosis; Pancreatic Diseases - drug therapy; Pancreatic Diseases - physiopathology; Pancreatitis; Patient compliance; Prospective Studies; Protease inhibitors; Protease Inhibitors - pharmacology; Proteases; Severity of Illness Index; Surgical Oncology; Treatment Outcome; Ultrasound imaging; Mild chronic pancreatitis; Camostat mesilate; Dyspepsia
• ISSN: 0944-1174; 1435-5922
• DOI: 10.1007/s00535-009-0148-1

Background The aim of the present study was to examine the potential efficacy of camostat mesilate, a protease inhibitor, against dyspepsia associated with non-alcoholic mild pancreatic disease. Methods Patients with upper abdominal pain suggesting pancreatic disease (persistent over hours, pain aggravated by ingestion of food, epigastric pain radiating to the back), without a history of alcohol consumption and who exhibited no abnormalities regarding serum amylase and lipase, ultrasonography, CT and upper gastrointestinal endoscopy, were prescribed 200 mg camostat mesilate three times daily for 2 weeks. The patients were subjected to endoscopic ultrasonography (EUS) while under treatment and were distributed into those who had 4 or more suggestive findings of chronic pancreatitis (suspected pancreatic disease group), 2 or 3 (equivalent group) and those with 1 or no findings (control group). Symptom severity was recorded before and after treatment using a 10-cm visual analog scale (VAS). Results Among 95 patients, 40 were in the suspected pancreatic disease group, 30 were in the equivalent group and 25 served as controls. A significant intra- and intergroup improvement of symptoms was observed not only in the suspected pancreatic disease group but also in the equivalent group. Conclusions Camostat mesilate may serve as a therapeutic agent for patients with dyspepsia associated with mild pancreatic disease, who do not habitually drink alcohol.