Proton pump inhibitor-refractory gastroesophageal reflux disease: challenges and solutions

Mermelstein, Joseph; Mermelstein, Alanna Chait; Chait, Maxwell M

doi:10.2147/ceg.s121056

Cited by 63 publications

(56 citation statements)

References 199 publications

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“…This observation is in accordance with a previous study showing that symptoms mainly decreased during the first 6 weeks of treatment . Interestingly, our statistical analysis did not report significant differences between the improvement in acid, nonacid, and mixed LPR, although nonacid LPR has long been suggested as reflux that is resistant to medical treatment . The good improvement of acid, nonacid, and mixed refluxes can be attributed to our personalized therapeutic approach consisting of the associated use of PPIs, alginate, and/or magaldrate according to the MII‐pH monitoring characteristics.…”

Section: Discussionsupporting

confidence: 91%

“…36 Interestingly, our statistical analysis did not report significant differences between the improvement in acid, nonacid, and mixed LPR, although nonacid LPR has long been suggested as reflux that is resistant to medical treatment. 37,38 The good improvement of acid, nonacid, and mixed refluxes can be attributed to our personalized therapeutic approach consisting of the associated use of PPIs, alginate, and/or magaldrate according to the MII-pH monitoring characteristics. According to our definition of nonacid LPR, the majority of patients with nonacid reflux had a few acidic reflux episodes.…”

Section: Discussionmentioning

confidence: 99%

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Validity and reliability of the reflux symptom score

Lechien¹,

Bobin²,

et al. 2019

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Objectives/Hypothesis To develop and validate the Reflux Symptom Score (RSS), a self‐administered patient‐reported outcome questionnaire for patients with laryngopharyngeal reflux (LPR). Study Design Prospective controlled study. Methods A total of 113 patients with LPR were enrolled and treated with diet and 3 months of pantoprazole, alginate, and/or magaldrate depending on the LPR characteristics (acid, nonacid, or mixed). Eighty asymptomatic individuals completed the study. Patients and controls completed the RSS twice within a 7‐day period to assess test‐retest reliability. Internal consistency was measured using Cronbach's α for the RSS items in patients and controls. Validity was assessed by comparing the baseline RSS with the Reflux Symptom Index (RSI) and Voice Handicap Index (VHI). Seventy‐seven patients completed the RSS at baseline and after 6 and 12 weeks of treatment to assess responsiveness to change. The RSS cutoff for determining the presence and absence of LPR was examined by receiver operating characteristic analysis. Results Test‐retest reliability (rs = 0.921) and internal consistency reliability (α = 0.969) were high. RSS exhibited high external validity indicated by a significant correlation with the RSI (rs = 0.831). Internal validity was excellent based on the higher RSS in patients compared with controls (P = .001). RSS, RSI, and VHI scores significantly improved from pre‐ to posttreatment, indicating a high responsiveness to change. RSS >13 can be considered suggestive of LPR‐related symptoms. RSS was not influenced by the occurrence of gastroesophageal reflux disease, LPR subtypes, or patient characteristics. Conclusions RSS is a self‐administered patient‐reported outcome questionnaire that demonstrates high reliability and excellent criterion‐based validity. RSS can be used in diagnosing and monitoring LPR disease. Level of Evidence 3b Laryngoscope, 130:E98–E107, 2020

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Validity and reliability of the reflux symptom score

Lechien¹,

Bobin²,

et al. 2019

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“…[6][7][8][9] Moreover, there are patients with GERD that is refractory to typical PPI therapy worldwide. 10 Overcoming these concerns requires the development of new drugs to treat GERD.…”

Section: What Is K Nown and Objec Tivementioning

confidence: 99%

The first case of tegoprazan‐induced urticaria

Sim

Park

et al. 2020

J Clin Pharm Ther

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What is known and objective Tegoprazan induces adverse drug reactions during clinical trials; however, tegoprazan‐induced urticaria has not been reported. Here, we describe the first case of this. Case description A 55‐year‐old woman presented with acute urticaria with pruritus after taking the gastro‐oesophageal reflux disease medication, tegoprazan. Urticaria disappeared after tegoprazan discontinuation. In an oral provocation test, after taking 10% of tegoprazan, she developed pruritus, and after taking 30%, she developed urticaria on her back. What is new and conclusion This is the first case of urticaria induced by tegoprazan. Physicians should understand the possibility of a tegoprazan‐induced hypersensitivity reactions.

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“…Studies in patients with EE have shown high healing rates (88%‐96%) after 8‐week treatment with a PPI once daily . However, some patients may have endoscopic evidence of oesophagitis and/or reflux symptoms despite PPI therapy …”

Section: Introductionmentioning

confidence: 99%

Randomised phase 3 trial: tegoprazan, a novel potassium‐competitive acid blocker, vs. esomeprazole in patients with erosive oesophagitis

Lee

Son²,

Kim

et al. 2019

Aliment Pharmacol Ther

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Summary Background Tegoprazan is a novel potassium‐competitive acid blocker that has a fast onset of action and can control gastric pH for a prolonged period, which could offer clinical benefit in acid‐related disorders. Aim To confirm the non‐inferiority of tegoprazan to esomeprazole in patients with erosive oesophagitis (EE). Methods In this multicentre, randomised, double‐blind, parallel‐group comparison study, 302 Korean patients with endoscopically confirmed EE (Los Angeles Classification Grades A‐D) were randomly allocated to either tegoprazan (50 or 100 mg) or esomeprazole (40 mg) treatment groups for 4 or 8 weeks. The primary endpoint was the cumulative proportion of patients with healed EE confirmed by endoscopy up to 8 weeks from treatment initiation. Symptoms, safety and tolerability were also assessed. Results The cumulative healing rates at week 8 were 98.9% (91/92), 98.9% (90/91) and 98.9% (87/88) for tegoprazan 50 mg, tegoprazan 100 mg and esomeprazole 40 mg, respectively. Both doses of tegoprazan were non‐inferior to esomeprazole 40 mg. The incidence of adverse events was comparable among the groups, and tegoprazan was well‐tolerated. Conclusion Once daily administration of tegoprazan 50 or 100 mg showed non‐inferior efficacy in healing EE and tolerability to that of esomeprazole 40 mg.

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Proton pump inhibitor-refractory gastroesophageal reflux disease: challenges and solutions

Cited by 63 publications

References 199 publications

Validity and reliability of the reflux symptom score

Validity and reliability of the reflux symptom score

The first case of tegoprazan‐induced urticaria

Randomised phase 3 trial: tegoprazan, a novel potassium‐competitive acid blocker, vs. esomeprazole in patients with erosive oesophagitis

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