Prediction of response to PPI therapy and factors influencing treatment outcome in patients with GORD: a prospective pragmatic trial using pantoprazole

BMC Gastroenterology

Research Article

Hubert Mönnikes¹  Holger Schmitt²  Anne Tholen³  Robert C Heading⁴ 

[1] Department of Medicine, Martin-Luther Hospital, Academic Teaching Hospital of Charité Universitätsmedizin, Berlin, Germany;Nycomed GmbH, Constance, Germany;Nycomed International Management GmbH, Zurich, Switzerland;Retired Gastroenterologist, Edinburgh, UK;

关键词: Irritable Bowel Syndrome;    Proton Pump Inhibitor Therapy;    Pylorus Status;    Functional Heartburn;    Proton Pump Inhibitor Treatment;   

DOI  :  10.1186/1471-230X-11-52

 received in 2010-12-22, accepted in 2011-05-11,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundManagement of patients with gastro-oesophageal reflux disease (GORD) can be assisted by information predicting the likely response to proton pump inhibitor (PPI) treatment. The aim was to undertake a study of GORD patients designed to approximate ordinary clinical practice that would identify patient characteristics predicting symptomatic response to pantoprazole treatment.Methods1888 patients with symptoms of GORD were enrolled in a multicentre, multinational, prospective, open study of 8 weeks pantoprazole treatment, 40 mg daily. Response was assessed by using the ReQuest™ questionnaire, by the investigator making conventional clinical enquiry and by asking patients about their satisfaction with symptom control. Factors including pre-treatment oesophagitis, gender, age, body mass index (BMI), Helicobacter pylori status, anxiety and depression, and concurrent IBS symptoms were examined using logistic regression to determine if they were related to response, judged from the ReQuest™-GI score.ResultsPoorer treatment responses were associated with non-erosive reflux disease, female gender, lower BMI, anxiety and concurrent irritable bowel syndrome symptoms before treatment. No association was found with age, Helicobacter pylori status or oesophagitis grade. Some reflux-related symptoms were still present in 14% of patients who declared themselves 'well-satisfied' with their symptom control.ConclusionsSome readily identifiable features help to predict symptomatic responses to a PPI and consequently may help in managing patient expectation. ClinicalTrial.gov identifier: NCT00312806.

【 授权许可】

CC BY   
© Heading et al; licensee BioMed Central Ltd. 2011