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Risk factors for low response to proton-pump inhibitor treatment in reflux esophagitis and non-erosive reflux disease evaluated by the frequency scale for the symptoms of gastroesophageal reflux disease

Abstract

Background

This study aimed to evaluate risk factors for resistance to proton-pump inhibitor (PPI) therapy among patients with reflux esophagitis (RE) and nonerosive reflux disease (NERD) in gastroesophageal reflux disease (GERD) using a standardized questionnaire in Japan: the Frequency Scale for the Symptoms of Gastroesophageal Reflux Disease (FSSG).

Methods

One hundred fifty-eight patients who underwent upper gastrointestinal endoscopy were enrolled: 87 were diagnosed with RE (mean age: 59.5 ± 15.1 years; male/female: 47/39) and 71 with NERD (mean age 53.0 ± 17.6 years; male/female 22/49). The patients were divided into two groups according to improvement after PPI treatment evaluated by FSSG: rapid responders were patients with ≥50 % improvement according to FSSG, and low responders were those with <50 % improvement according to FSSG. All patients were treated with the PPI rabeprazole (10 mg/day) for 4 weeks.

Results

Response rate to PPI therapy was 65.5 % (57/87) in RE and 54.9 % (39/71) in NERD, indicating that the PPI treatment was more effective for RE. In RE, risk factors for PPI resistance indicated by univariate analysis were low stature and high body mass index. Low stature was a risk factor in multivariate analysis. With regard to NERD, univariate analysis indicated that female gender, high stature, low body weight, and low total FSSG score were risk factors for PPI resistance. Low FSSG score was a risk factor in multivariate analysis.

Conclusions

By the present study, we identified the risk factors for PPI resistance in RE and GERD using FSSG.

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Acknowledgments

This study was partly supported by Eisai Co., Tokyo, Japan.

Ethical Statement

Written informed consent was obtained from all patients before study entry. The study was conducted in accordance with the Helsinki Declaration of the World Medical Association under the approval of the Ethics Committee in each institute.

Conflict of interest

None.

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Correspondence to Kayo Akutagawa.

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Akutagawa, K., Iwakiri, R., Hara, M. et al. Risk factors for low response to proton-pump inhibitor treatment in reflux esophagitis and non-erosive reflux disease evaluated by the frequency scale for the symptoms of gastroesophageal reflux disease. Esophagus 12, 225–232 (2015). https://doi.org/10.1007/s10388-014-0477-x

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  • DOI: https://doi.org/10.1007/s10388-014-0477-x

Keywords

  • Multivariate analysis
  • Proton-pump inhibitor
  • Questionnaires
  • Rabeprazole
  • Risk Factors