Maintenance Therapy in Gastro-oesophageal Reflux Disease

M, Bixquert

doi:10.2165/00003495-200565001-00009

Cited by 8 publications

(9 citation statements)

References 27 publications

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“…In CD patients at 6 months FU, the majority (80%) did not present signs of recurrence despite the withdrawal of PPI treatment after GFD, while in the control group we observed a progressive increase in the rate of recurrence which after 12 months was significantly higher than that observed in CD patients. The results obtained in the controls are similar to those observed by others, in fact Bixquert reported that in the general population 25–45% of patients with NERD remain in remission 6 months after the discontinuation of PPI treatment 5 …”

Section: Discussionsupporting

confidence: 90%

“…GERD is a chronic condition showing a trend to recurrence 3 with a 4‐week symptomatic response rate to proton‐pump inhibitor (PPI) treatment of 56% in those with erosive esophagitis (EE) and 37% in those with nonerosive reflux disease (NERD) 4 . Furthermore, if long‐term treatment is administered, by the disease's natural history itself, as it is not important whether it is erosive or nonerosive: once the successful initial treatment is withdrawn, only 10–25% of the patients with previous esophagitis and 25–45% of those with the nonerosive form, remain in remission after 6 months 5 . Cuomo et al 6 .…”

Section: Introductionmentioning

confidence: 99%

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Effect of gluten‐free diet on preventing recurrence of gastroesophageal reflux disease–related symptoms in adult celiac patients with nonerosive reflux disease

Usai

Manca

Cuomo

et al. 2008

J of Gastro and Hepatol

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Effect of gluten‐free diet on preventing recurrence of gastroesophageal reflux disease–related symptoms in adult celiac patients with nonerosive reflux disease

Usai

Manca

Cuomo

et al. 2008

J of Gastro and Hepatol

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“…regimen) are usually required for patients who initially had moderate/severe ERD [9]. Maintenance PPI therapy is well tolerated for up to 10 years of continuous use, and without apparent signs of tachyphylaxis [39]. A continuous use of PPIs is not necessary in many patients [8].…”

Section: Optimizing Therapy Of Gerdmentioning

confidence: 99%

Potential Options to Optimize Therapy of Gastroesophageal Reflux Disease with Proton Pump Inhibitors

et al. 2007

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Proton pump inhibitors (PPIs) are antisecretory agents that are widely used in the short- and long-term management of gastroesophageal reflux disease (GERD) to relieve symptoms, heal esophagitis, and prevent complications, such as strictures and Barrett’s esophagus. The total healthcare costs of GERD are high, especially for maintenance treatment. Therefore, the choice of cost-effective therapeutic options is an ineluctable challenge for public health authorities, third-party payers, and patients. In some European Union countries, a recent trend of public health authorities is to promote the choice of less expensive PPIs, regardless of their antisecretory potency – this in spite of the evidence that newer PPIs provide superior symptom relief and esophageal erosion healing compared to earlier drugs. Several large clinical trials have demonstrated the superiority of esomeprazole over other PPIs at standard doses for both initial and continuous maintenance therapy in patients with moderate/severe erosive esophagitis. The non-erosive GERD poses a major challenge as this condition appears more frequently to be less responsive to PPIs. The use of PPIs with the strongest antisecretory properties might reveal to be more adequate and cost-effective, particularly for this indication.

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“…For patients with RE, short-term management goals include prompt resolution of symptoms and healing of erosions (6). However, following initial healing of RE, few patients remain in endoscopic and symptomatic remission unless provided with maintenance therapy (7). Therefore, long-term maintenance therapy is necessary for the prevention of recurrent RE and GERD symptoms in a high proportion of patients.…”

Section: Introductionmentioning

confidence: 99%

Management of reflux esophagitis: does the choice of proton pump inhibitor matter?

Labenz

Armstrong

Leodolter³

et al. 2015

Int J Clin Pract

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Background: Proton pump inhibitors (PPIs) are the treatment of choice for reflux esophagitis (RE). The effectiveness of PPIs throughout RE management, from healing to maintenance, has not been fully studied. Aim: To compare esomeprazole with lansoprazole or pantoprazole for RE management using a management model. Methods: Data from six studies comparing esomeprazole with lansoprazole or pantoprazole for healing (4-8 weeks) or maintenance of healing (6 months) of RE were incorporated into hypothetical management models to determine the proportion of patients in endoscopic remission after sequential healing and maintenance therapy, assuming that patients received the same PPI throughout. The number needed to treat (NNT) to achieve one more patient in remission with esomeprazole vs. other PPIs was estimated. The hypothetical model was validated using results from the EXPO study, which compared esomeprazole with pantoprazole for RE healing and maintenance. Results: Overall, esomeprazole 40 mg produced higher rates of healing (life-table estimates) than lansoprazole 30 mg (82.4-92.6% vs. 77.5-88.8%; p < 0.01) or pantoprazole 40 mg (95.5% vs. 92.0%; p < 0.001) and higher rates of endoscopic and symptomatic remission at 6 months than lansoprazole (83.0-84.8% vs. 74.0-75.9%; p < 0.001; life-table estimates) or pantoprazole (70.9% vs. 59.6%; p < 0.0001; observed rates). In the hypothetical management model, the NNT for esomeprazole was 9 vs. lansoprazole and 8 vs. pantoprazole. The actual NNT for esomeprazole vs. pantoprazole in the EXPO study was 9 (95% confidence interval: 6; 16). Conclusions: In this management model, esomeprazole was more effective than either lansoprazole or pantoprazole for maintaining remission after sequential healing and 6 months' maintenance therapy for RE. What's knownNumerous studies have demonstrated the efficacy of proton pump inhibitors (PPIs) for initial healing of reflux esophagitis and maintenance of endoscopic remission. However, the effect of different PPIs in achieving healing and then maintaining remission has not been fully studied. What's newIn this management model, esomeprazole offers improved clinical efficacy compared with lansoprazole or pantoprazole throughout the course of management (i.e. initial healing of reflux esophagitis followed by maintenance of remission)

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Maintenance Therapy in Gastro-oesophageal Reflux Disease

Cited by 8 publications

References 27 publications

Effect of gluten‐free diet on preventing recurrence of gastroesophageal reflux disease–related symptoms in adult celiac patients with nonerosive reflux disease

Effect of gluten‐free diet on preventing recurrence of gastroesophageal reflux disease–related symptoms in adult celiac patients with nonerosive reflux disease

Potential Options to Optimize Therapy of Gastroesophageal Reflux Disease with Proton Pump Inhibitors

Management of reflux esophagitis: does the choice of proton pump inhibitor matter?

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