Costs and efficacy of three different esomeprazole treatment strategies for long‐term management of gastro‐oesophageal reflux symptoms in primary care

Meineche-Schmidt, Villy; Juhl, Henrik Hauschildt; Østergaard, Jette Buch; Luckow, Anders; Hvenegaard, Anne

doi:10.1111/j.1365-2036.2004.01916.x

Cited by 43 publications

(31 citation statements)

References 12 publications

(12 reference statements)

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“…Full disappearance of symptoms is important to improve QOL [43]. As to medical treatment, PPIs are more effective in improving QOL than H2RAs or prokinetic drugs [44,45]. Acid regurgitation during night-time could induce sleep disturbance and noncardiac pain.…”

Section: Medical Treatmentmentioning

confidence: 99%

Evidence-based clinical practice guidelines for gastroesophageal reflux disease 2015

et al. 2016

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As an increase in gastroesophageal reflux disease (GERD) has been reported in Japan, and public interest in GERD has been increasing, the Japanese Society of Gastroenterology published the Evidence-based Clinical Practice Guidelines for GERD (1st edition) in 2009. Six years have passed since its publication, and there have been a large number of reports in Japan concerning the epidemiology, pathophysiology, treatment, and Barrett's esophagus during this period. By incorporating the contents of these reports, the guidelines were completely revised, and a new edition was published in October 2015. The revised edition consists of eight items: epidemiology, pathophysiology, diagnosis, internal treatment, surgical treatment, esophagitis after surgery of the upper gastrointestinal tract, extraesophageal symptoms, and Barrett's esophagus. This paper summarizes these guidelines, particularly the parts related to the treatment for GERD. In the present revision, aggressive proton pump inhibitor (PPI) maintenance therapy is recommended for severe erosive GERD, and on-demand therapy or continuous maintenance therapy is recommended for mild erosive GERD or PPI-responsive non-erosive GERD. Moreover, PPI-resistant GERD (insufficient symptomatic improvement and/or esophageal mucosal break persisting despite the administration of PPI at a standard dose for 8 weeks) is defined, and a standard-dose PPI twice a day, change in PPI, change in the PPI timing of dosing, addition of a prokinetic drug, addition of rikkunshito (traditional Japanese herbal medicine), and addition of histamine H2-receptor antagonist are recommended for its treatment. If no improvement is observed even after these treatments, pathophysiological evaluation with esophageal impedancepH monitoring or esophageal manometry at an expert facility for diseases of the esophagus is recommended.

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Section: Medical Treatmentmentioning

confidence: 99%

Evidence-based clinical practice guidelines for gastroesophageal reflux disease 2015

et al. 2016

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“…An alternative mode of therapy for milder disease is intermittent treatment, whereby a sufferer is directed to take a predetermined short-course (typically 2 weeks) of therapy when symptoms recur [52]. Moreover, given what is known about medication compliance in general, it is unlikely that many patients outside clinical trials take their medications as directed more than 50% of the time.…”

Section: Role Of Over-the-counter Treatmentmentioning

confidence: 99%

Management of Reflux Symptoms with Over-the-Counter Proton Pump Inhibitors: Issues and Proposed Guidelines

Haag¹,

Andrews²,

Katelaris³

et al. 2009

Digestion

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Background: Symptoms of gastroesophageal reflux are widely prevalent. There is a continuum between subjects with mild reflux symptoms and those severely affected by gastroesophageal reflux disease (GERD). Both groups may at times access over-the-counter (OTC) therapies. For the purpose of this review, relevant papers, including national and international guidelines were reviewed and recommendations made for appropriate use of OTC proton pump inhibitor (PPI) therapy. Results: PPIs are the gold standard for treatment of reflux symptoms. OTC therapy with histamine₂ receptor antagonists (H2RAs) also plays a role. For the majority affected by reflux symptoms, effective symptom control is the most important outcome, as only a subgroup requires investigations or interventions. However, patients with alarm features (i.e. troublesome dysphagia, weight loss, predominant upper abdominal pain) are not recommended for OTC therapy and need prompt medical referral. Frequent relapses or failure to adequately respond to OTC therapy are additional triggers for medical assessment. Conclusions: OTC treatment of typical reflux symptoms (acid regurgitation, heartburn) with antacids and H2RAs is now accepted as safe and results in short-term relief of symptoms. There is no evidence of additional risk with OTC PPIs compared to these existing OTC therapies and PPIs are significantly more efficacious.

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“…Regarding gastrooesophageal reflux disease (GERD) several trials [1][2][3] have been published as well as consensus reports from specialists, 4 systematic reviews 5 and Cochrane reviews. 6 Results from randomized-controlled trials are considered best evidence.…”

Section: Introductionmentioning

confidence: 99%

“…Or is everything 'back to normal' after the trial? In a prospective, open, randomized multicentre study, the ONE trial 3 a total of 1357 patients with symptoms suggestive of GERD were randomized to 6-month treatment with either on-demand treatment (esomeprazole 20 mg) or treatment courses (with esomeprazole 40 mg daily for 2 or 4 weeks), i.e. one study arm reflected patient control and the other two arms General Practitioner (GP) control with the management.…”

Section: Introductionmentioning

confidence: 99%

Participation in a clinical trial influences the future management of patients with gastro‐oesophageal reflux disease in general practice

Meineche-Schmidt¹,

Hvenegaard

Juhl

2006

Aliment Pharmacol Ther

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Costs and efficacy of three different esomeprazole treatment strategies for long‐term management of gastro‐oesophageal reflux symptoms in primary care

Cited by 43 publications

References 12 publications

Evidence-based clinical practice guidelines for gastroesophageal reflux disease 2015

Evidence-based clinical practice guidelines for gastroesophageal reflux disease 2015

Management of Reflux Symptoms with Over-the-Counter Proton Pump Inhibitors: Issues and Proposed Guidelines

Participation in a clinical trial influences the future management of patients with gastro‐oesophageal reflux disease in general practice

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