Esomeprazole 40mg and 20mg is efficacious in the long-term management of patients with endoscopy-negative gerd: A placebo-controlled trial of on-demand therapy for 6 months

Talley, Nicholas J.; Venables, T. L.; Green, Jonathan R.; Armstrong, David; O'kane, K. P. J.; Giaffer, M. H.; Bardhan, Karna Dev; Carlsson, R.; Chen, Samuel; Hasselgren, Gunnar

doi:10.1016/s0016-5085(00)84770-8

Cited by 14 publications

(8 citation statements)

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“…On‐demand therapy for NERD patients is a logical alternative to intermittent therapy, that is the drug is taken only when symptoms recur and is continued until the symptoms are relieved. To date, three large, double‐blind studies of on‐demand therapy have investigated the effectiveness of such an approach 71–73 . The primary endpoint was the proportion of patients who discontinued treatment because of inadequate control of heartburn.…”

Section: Working Party 3: Treatment Strategies and Treatment Options mentioning

confidence: 99%

Report of the Asia–Pacific consensus on the management of gastroesophageal reflux disease

Fock

Talley

Hunt

et al. 2004

J of Gastro and Hepatol

103

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This report summarizes the conclusions and recommendations of a panel of gastroenterologists practising in the Asia-Pacific region. The group recognized that although gastroesophageal reflux disease (GERD) is less common and milder in endoscopic severity in Asia than in the West, there is nevertheless data to suggest an increasing frequency of the disease. During a 2-day workshop, the evidence for key issues in the diagnosis and clinical strategies for the management of the disease was evaluated, following which the recommendations were made and debated. The consensus report was presented at the Asia-Pacific Digestive Week 2003 in Singapore for ratification. Upper gastrointestinal (GI) endoscopy is the gold standard for the diagnosis of erosive GERD. There is no gold standard for the diagnosis of non-erosive GERD (NERD). Diagnosis therefore relies on symptoms, a positive 24-h pH study or a response to a course of proton pump inhibitor (PPI) treatment. The goals of treatment for GERD are to heal esophagitis, relieve symptoms, maintain the patient free of symptoms, improve quality of life and prevent complications. The PPI are the most effective medical treatment. Following initial treatment, on-demand therapy may be effective in some patients with NERD or mild (GI) erosive esophagitis. Anti-reflux surgery by a competent surgeon could achieve a similar outcome, although there is an operative mortality of 0.1-0.8%. The decision is dependent on the patient's preference and the availability of surgical expertise. Currently, endoscopic treatment should be performed only in the context of a clinical trial. Treatment of patients with typical GERD symptoms without alarm features in primary care could begin with PPI for 2 weeks followed by a further 4 weeks before going to on-demand therapy.

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Section: Working Party 3: Treatment Strategies and Treatment Options mentioning

confidence: 99%

Report of the Asia–Pacific consensus on the management of gastroesophageal reflux disease

Fock

Talley

Hunt

et al. 2004

J of Gastro and Hepatol

103

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“…On‐demand therapy with the new generation PPI esomeprazole is a new approach to the long‐term management of GORD patients without oesophagitis. This symptom‐driven regimen allows patients to take maintenance therapy only when necessary to control their recurrent symptoms 33,34 . Although more studies are needed, on‐demand therapy for uncomplicated GORD without erosions appears to offer a cost‐effective means to provide maintenance therapy with a PPI.…”

Section: Discussionmentioning

confidence: 99%

Managing Gastro‐oesophageal Reflux Disease in Primary Care

Nathoo

2001

Int J Clinical Practice

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SUMMARYThe National Institute for Clinical Excellence recently issued guidance on the use of proton pump inhibitors (PPIs) in the management of dyspepsia, including gastro‐oesophageal reflux disease (GORD). GORD is a common disorder that reduces quality of life and can indicate serious disease such as reflux oesophagitis. The symptoms of GORD must be distinguished from those of other diseases, such as functional dyspepsia or cardiac problems. Furthermore, atypical alarm symptoms, such as bleeding or sudden weight loss, require urgent further investigation. Most GORD is uncomplicated and can be treated using management algorithms that make the best use of resources. Newer strategies such as ‘step‐down’ or ‘on‐demand’ therapy can cost‐effectively improve the long‐term management and quality of life of patients with recurrent GORD.

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“…L'esame della letteratura clinica e delle indicazioni autorizzate avrebbe consentito agli autori di rilevare che la dose più elevata, 40 mg, corrisponde alla dose raccomandata solo nel trattamento acuto dell'esofagite che non rappresenta l'indicazione principale. Inoltre ci sembra corretto precisare che, a differenza di quanto rilevato dagli autori che citano solo due degli studi clinici pubblicati su esomeprazolo, sono disponibili numerosi studi in cui la posologia del prodotto è pari a 20 mg, dall'inizio dello studio stesso o dopo l'effettuazione della fase di terapia acuta [11,[13][14][15][16][17][18][19][20].…”

Section: Dosaggio DI Esomeprazolounclassified

Commenti al lavoro di Colombo GL, Muzio A “Gli inibitori di pompa protonica nelle patologie acido-correlate: il ruolo di rabeprazolo in una strategia di cost minimisation”

Rossi

Benelli

2003

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Esomeprazole 40mg and 20mg is efficacious in the long-term management of patients with endoscopy-negative gerd: A placebo-controlled trial of on-demand therapy for 6 months

Cited by 14 publications

References 0 publications

Report of the Asia–Pacific consensus on the management of gastroesophageal reflux disease

Report of the Asia–Pacific consensus on the management of gastroesophageal reflux disease

Managing Gastro‐oesophageal Reflux Disease in Primary Care

Commenti al lavoro di Colombo GL, Muzio A “Gli inibitori di pompa protonica nelle patologie acido-correlate: il ruolo di rabeprazolo in una strategia di cost minimisation”

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