Symptom profile in partial responders to a proton pump inhibitor compared with treatment-naïve patients with gastroesophageal reflux disease: a post hoc analysis of two study populationsReportar como inadecuado




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BMC Gastroenterology

, 14:177

Gastroesophageal disorders

Abstract

BackgroundPartial response to proton pump inhibitor PPI therapy poses a healthcare challenge. This study aimed to compare symptom profiles in partial PPI responders and treatment-naïve patients with gastroesophageal reflux disease GERD.

MethodsA post hoc analysis of data from two studies was performed. Partial PPI responders with GERD n = 580; NCT00703534 had frequent ≥ 3 days-week heartburn and-or regurgitation despite PPI therapy; patients with no improvement were excluded. Treatment-naïve patients with GERD diagnosed by endoscopy and pH-metry; n = 203; NCT00291746 had frequent ≥ 3 days-week upper gastrointestinal symptoms. The Gastrointestinal Symptom Rating Scale GSRS was completed by all patients at study entry and by treatment-naïve patients after PPI therapy.

ResultsThe highest mean 95% confidence interval discomfort scores were reported in the Reflux heartburn, regurgitation, Indigestion, and Abdominal pain domains of the GSRS, both in partial PPI responders 4.3 4.2–4.4, 3.7 3.6–3.8, and 3.4 3.3–3.5, respectively and in treatment-naïve patients 3.5 3.3–3.7, 3.6 3.4–3.7, and 3.1 3.0–3.3, respectively. Partial PPI responders reported more discomfort than treatment-naïve patients in the Reflux, Abdominal pain, and Constipation domains 4.3 4.2–4.4 vs. 3.5 3.3–3.7, 3.4 3.3–3.5 vs. 3.1 3.0–3.3, and 2.5 2.4–2.6 vs. 2.1 1.9–2.2, respectively. All GSRS domain scores improved in treatment-naïve patients following PPI therapy.

ConclusionsSymptom patterns in partial PPI responders were similar to those in treatment-naïve patients with GERD, but partial PPI responders experienced more severe reflux, abdominal pain, and constipation than did treatment-naïve patients.

KeywordsAbdominal pain Constipation Heartburn Proton pump inhibitors Regurgitation Gastric AbbreviationsBMIBody mass index

CIConfidence interval

GERDGastroesophageal reflux disease

GSRSGastrointestinal Symptom Rating Scale

IBSIrritable bowel syndrome

PPIProton pump inhibitor

PROPatient-reported outcome.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-230X-14-177 contains supplementary material, which is available to authorized users.

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Autor: Nimish Vakil - Anna Niklasson - Hans Denison - Anna Rydén

Fuente: https://link.springer.com/







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