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Erschienen in: Esophagus 2/2021

02.11.2020 | Original Article

The early therapeutic response at 2 weeks is a crucial predictor of proton pump inhibitor-refractory gastroesophageal reflux disease

verfasst von: Maiko Ogawa, Seiji Arihiro, Nobuyuki Matsuhashi, Takashi Joh, Kazuhide Higuchi, Katsuhiko Iwakiri, Takeshi Kamiya, Noriaki Manabe, Kimio Isshi, Tatsuya Nakada, Atsushi Hokari, Masayuki Saruta, Atsushi Oshio, Ken Haruma, Koji Nakada

Erschienen in: Esophagus | Ausgabe 2/2021

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Abstract

Background

In recent years, the prevalence of proton pump inhibitor (PPI)-refractory gastroesophageal reflux disease (GERD) has been increasing, posing a clinical obstacle to improving the management of GERD patients. The ability of known predictive factors to explain therapeutic response to PPI remains insufficient. Therefore, we examined whether the addition of early therapeutic response to PPI as an explanatory variable may increase the predictive power for PPI-refractory GERD.

Methods

The severity and therapeutic response of GERD symptoms to PPI were evaluated using the GastroEsophageal Reflux and Dyspepsia Therapeutic Efficacy and Satisfaction Test (GERD-TEST) questionnaire at baseline and at 2 and 4 weeks after treatment. The relevance of the therapeutic effect of PPI at 2 weeks compared to that at 4 weeks was examined in 301 patients with GERD. Independent predictive factors for refractory GERD at 4 weeks of PPI therapy were examined in 182 patients. The effect of various clinical factors, including the early response to PPI, was assessed using multiple regression analysis.

Results

The number of PPI-therapy responders increased significantly with the duration of treatment (p < 0.0001). The response to PPI therapy at 2 weeks was significantly correlated with that at 4 weeks (p < 0.0001). Multiple regression analysis revealed that the therapeutic response to PPI at 2 weeks was by far the strongest predictor of the therapeutic effect at 4 weeks among all clinical factors.

Conclusions

Medication change for PPI-refractory GERD at 2 weeks may be an efficacious therapeutic strategy to improve patients’ quality of life.
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Metadaten
Titel
The early therapeutic response at 2 weeks is a crucial predictor of proton pump inhibitor-refractory gastroesophageal reflux disease
verfasst von
Maiko Ogawa
Seiji Arihiro
Nobuyuki Matsuhashi
Takashi Joh
Kazuhide Higuchi
Katsuhiko Iwakiri
Takeshi Kamiya
Noriaki Manabe
Kimio Isshi
Tatsuya Nakada
Atsushi Hokari
Masayuki Saruta
Atsushi Oshio
Ken Haruma
Koji Nakada
Publikationsdatum
02.11.2020
Verlag
Springer Singapore
Erschienen in
Esophagus / Ausgabe 2/2021
Print ISSN: 1612-9059
Elektronische ISSN: 1612-9067
DOI
https://doi.org/10.1007/s10388-020-00792-z

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