Baclofen and gastroesophageal reflux disease: seeing the forest through the trees

Clarke, John O.; Fernandez‐Becker, Nielsen; Regalia, Kirsten; Triadafilopoulos, George

doi:10.1038/s41424-018-0010-y

Cited by 19 publications

(9 citation statements)

References 13 publications

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“…30 TLESRs are vasovagally induced reflexes that are triggered by gastric distention and work via several neurotransmitters and receptors, including the GABA B receptor. 31 Through its GABA B receptor activity, baclofen inhibits TLESRs, and has been shown to significantly inhibit gastroesophageal reflux disease (GERD) episodes in both healthy volunteers and in patients with reflux disease. [32][33][34] Other off-label uses.…”

Section: Off-label Usesmentioning

confidence: 99%

Baclofen therapeutics, toxicity, and withdrawal: A narrative review

et al. 2021

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Baclofen is an effective therapeutic for the treatment of spasticity related to multiple sclerosis, spinal cord injuries, and other spinal cord pathologies. It has been increasingly used off-label for the management of several disorders, including musculoskeletal pain, gastroesophageal reflux disease, and alcohol use disorder. Baclofen therapy is associated with potential complications, including life-threatening toxicity and withdrawal syndrome. These disorders require prompt recognition and a high index of suspicion. While these complications can develop following administration of either oral or intrathecal baclofen, the risk is greater with the intrathecal route. The management of baclofen toxicity is largely supportive while baclofen withdrawal syndrome is most effectively treated with re-initiation or supplementation of baclofen dosing. Administration of other pharmacologic adjuncts may be required to effectively treat associated withdrawal symptoms. This narrative review provides an overview of the historical and emerging uses of baclofen, offers practical dosing recommendations for both oral and intrathecal routes of administration, and reviews the diagnosis and management of both baclofen toxicity and withdrawal.

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Section: Off-label Usesmentioning

confidence: 99%

Baclofen therapeutics, toxicity, and withdrawal: A narrative review

et al. 2021

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“… 50 However, data on actual symptomatic improvement in patients with GERD is mixed, and believed to be secondary to the fact that baclofen also paradoxically decreases the initiation and frequency of esophageal secondary peristalsis, increasing the esophageal acid exposure time and hence GERD symptoms. 51 Patients considered for baclofen or prokinetics therapy must have exhaustive diagnostic testing performed to exclude other causes.…”

Section: Pharmacologic Therapymentioning

confidence: 99%

The Medical Management of Gastroesophageal Reflux Disease: A Narrative Review

Kröner

Cortés

Lukens

2021

J Prim Care Community Health

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Objective The medical management of gastroesophageal reflux disease (GERD) continues to evolve. Our aim was to systematically assess the literature to provide an updated review of the evidence on lifestyle modifications and pharmacological therapy for the management of GERD. Background The cornerstones of GERD medical management consist of lifestyle modifications and pharmacologic agents. Most recently, evidence has emerged linking anti-reflux pharmacologic therapy to adverse events, such as kidney injury, metabolic bone disease, myocardial infarction, and even dementia, among others. Methods A systematic search of the databases of PubMed/MEDLINE, Embase, and Cochrane Library was performed for articles on the medical management of GERD between inception and March 1, 2021. Conclusion Although pharmacological therapy has been associated with potential adverse events, further research is needed to determine if this association exists. For this reason, lifestyle modifications should be considered first-line, while pharmacologic therapy can be considered in patients in whom lifestyle modifications have proven to be ineffective in controlling their symptoms or cannot institute them. Naturally, extra-esophageal causes for GERD-like symptoms must be considered on suspected high-risk patients and excluded before considering treatment for GERD.

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“…However, its use is limited by central side effects including dizziness and somnolence. 100,101 Furthermore, the long-term efficacy has not been demonstrated. 102 There are several emerging therapeutic agents that show promise in the treatment of GERD.…”

Section: Medical Therapymentioning

confidence: 99%

“…The role of the stretch receptors in the fundus is also a mechanism being explored with the use of GABA agonists to aid in increased LES tone. However, its use is limited by central side effects including dizziness and somnolence 100,101 . Furthermore, the long‐term efficacy has not been demonstrated 102 .…”

Section: Medical Therapymentioning

confidence: 99%

Rethinking gastroesophageal reflux disorder

Banting

Badgery

Read

et al. 2020

Annals of the New York Academy of Sciences

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Gastroesophageal reflux disease (GERD) is a common clinical condition for which our understanding has evolved over the past decades. It is now considered a cluster of phenotypes with numerous anatomical and physiological abnormalities contributing to its pathophysiology. As such, it is important to first understand the underlying mechanism of the disease process for each patient before embarking on therapeutic interventions. The aim of our paper is to highlight the mechanisms contributing to GERD and review investigations and interpretation of these results. Finally, the paper reviews the available treatment modalities for this condition, ranging from medical intervention, endoscopic options through to surgery and its various techniques.

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Baclofen and gastroesophageal reflux disease: seeing the forest through the trees

Cited by 19 publications

References 13 publications

Baclofen therapeutics, toxicity, and withdrawal: A narrative review

Baclofen therapeutics, toxicity, and withdrawal: A narrative review

The Medical Management of Gastroesophageal Reflux Disease: A Narrative Review

Rethinking gastroesophageal reflux disorder

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