Table 2. Characteristics of studies evaluating the use of calcium channel blockers in achalasia.
| Study | Design | Sample size (n) | Previous achalasia treatment (n, %) | Drug (+/−formulation) | Significant reduction in LOS pressure | Symptomatic improvement (n, %) | Effect on pain |
Side effects (n, %) |
Intolerable side effects (n, %) | Follow-up |
|---|---|---|---|---|---|---|---|---|---|---|
| Bortolotti 19819 | RCT | 29 | 8 (28) | Nifedipine SL | Yes | 21 (72) | NR | 10 | 0 | 6–18 months |
| Bortolotti 199910 | RCS | 56 | NR | Nifedipine SL | NR | 39 (70) at 2 weeks, 13 (22) long-term | NR | unclear | 6 | Unclear |
| Coccia 199111 | RCT | 30 | NR | Nifedipine SL | Yes | 12 (71) | NR | unclear | 1 | 12–36 months |
| Gelfond 198212 | RCT | 15 | 3 (20) | Nifedipine SL | Yes (46.7%) | 8 (53) | NR | 2 | At least 1 | 5–14 months |
| Ghosh 199413 | RCS | 30† | NR | Nifedipine | Yes | Unclear‡ | NR | NR | NR | N/A |
| Robertson 198914 | Clinical trial | 35§ | 10 (29) | Nifedipine SL | No | 10 (67%) | NR | 3 | 0 | 1 month |
| Traube 198915 | RCT | 10 | 3 (30) | Nifedipine SL | Yes (28%) | Significant improvement in number of meals with dysphagia | NR | unclear | 1 | 6 weeks |
| Triadafilo-poulos 19918 | RCT | 10 | 2 (20) | Nifedipine, verapamil | Yes (range 4–43%) | No significant effect | No significant effect | NR | NR | 4 weeks |
| Yasawy 201416 | RCS | 31|| | 0 (0)¶ | Nifedipine | NR | 0 (0) | NR | NR | NR | 4 months |
ISDN, isosorbide dinitrate; LOS, lower esophageal sphincter; N/A, not applicable; NR, not reported; RCS, retrospective case series; RCT, randomized controlled trial; SL, sublingual.
†Study retrospectively examined 30 patients who had undergone pneumatic balloon dilatation. 12 patients received nifedipine.
‡Of patients aged 24–65 years old, five responded to pharmacological treatment, but it is not stated whether this was after nitrates or nifedipine. No patients >65years old responded to pharmacological treatment. All patients required pneumatic dilatation.
§Total sample size was 35, of which 15 had achalasia and were the only ones to receive nifedipine, 10 had achalasia and had undergone Heller’s myotomy, 10 were healthy subjects.
||Total sample size of the study was 31, of which five received nifedipine.
¶No previous endoscopic/surgical treatment.