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Prospective, observational study using rabeprazole in 455 patients with laryngopharyngeal reflux disease

  • Laryngology
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European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

The role of proton pump inhibitor in the treatment of laryngopharygneal reflux disease (LPRD) has been advocated, but there has been few reports dealing with large population based on time-related efficacy of rabeprazole. It was designed to assess the efficacy of rabeprazole and to evaluate which symptoms or findings varied significantly as medication sustained. Multiorgan, open-label cohort, prospective observational study was designed. We identified 1,142 patients with LPRD, and enrolled 455 patients, who participated fully in this survey and follow-up observation for 12 weeks. Reflux symptom index (RSI) and reflux finding score (RFS) were used to evaluate therapeutic efficacy. These parameters were evaluated at the 4th, 8th, and 12th weeks, respectively. Valid rate was used to explain improved proportion of patients after medication. The most common symptom was a globus sense in the throat. Posterior commissure hypertrophy was the most frequently encountered laryngoscopic finding. Female patients complained of heartburn and chest pain more than did male patients (P < 0.001), whereas male patients showed ventricular obliteration and erythematous changes more frequently than did female patients (P < 0.001). By RSI evaluation, scores gradually declined. Each item of the RSI improved at every visit (P < 0.001). Total RFS decreased progressively for 12 weeks and similar results were seen when every RFS item was individually examined. The proportion of patients who showed RSI and RFS falling by more than 50% after medication increased gradually as follow-up continued. This trend seemed to be significant (P < 0.001). Side effects of therapy were minimal. Despite the some constraints of an observational study, rabeprazole appeared to improve LPRD symptoms and signs. Prolonged medication at least 3 months may be beneficial to LPRD patients. Long-term medication effects require further evaluation.

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References

  1. Koufman JA, Aviv JE, Casiano RR, Shaw GY (2002) Laryngopharygeal reflux: position statement of the committee on speech, voice, and swallowing disorders of the American academy of otolaryngology-head and neck surgery. Otolaryngol Head Neck Surg 127:32–35

    Article  PubMed  Google Scholar 

  2. Altman KW, Stephes RM, Lyttle CS, Weiss KB (2005) Changing impact of gastroesophageal reflux in medical and otolaryngology practice. Laryngoscope 115:1145–1153

    Article  PubMed  Google Scholar 

  3. Postma GN (2000) Ambulatory pH monitoring methodology. Ann Otol Rhinol Laryngol Suppl 184(109):10–14

    PubMed  CAS  Google Scholar 

  4. Ulualp SO, Rodriguez S, Holmes-Wright CN (2007) Flexible laryngoscopy-guided pharyngeal pH monitoring in infants. Laryngoscope 117:577–580

    Article  PubMed  Google Scholar 

  5. Ali Mel S (2008) Laryngopharyngeal reflux: diagnosis and treatment of a controversial disease. Curr Opin Allergy Clin Immunol 8:28–33

    Article  Google Scholar 

  6. Belafsky PC, Postma GN, Koufman JA (2001) The validity and reliability of the reflux finding score (RFS). Laryngoscope 111:1313–1317

    Article  PubMed  CAS  Google Scholar 

  7. Belafsky PC, Postma GN, Koufman JA (2002) Validity and reliability of the reflux symptom index (RSI). J Voice 16:274–277

    Article  PubMed  Google Scholar 

  8. Wise S, Wise J, DelGaudio J (2006) Gastroesophageal reflux and laryngopharyngeal reflux in patients with sleep-disordered breathing. Otolaryngol Head Neck Surg 135:253–257

    Article  PubMed  Google Scholar 

  9. Ulualp SO, Toohill RJ, Shaker R (2001) Outcomes of acid suppressive therapy in patients with posterior laryngitis. Otolaryngol Head Neck Surg 124:16–22

    Article  PubMed  CAS  Google Scholar 

  10. Karkos PD, Benton J, Leong SC, Karkanevatos A, Badran K, Srinivasan VR, Temple RH, Issing WJ (2007) Trends in laryngopharyngeal reflux: a British ENT survey. Eur Arch Otorhinolaryngol 264:513–517

    Article  PubMed  CAS  Google Scholar 

  11. Wo JM, Grist WJ, Gussack G, Delgaudio JM, Waring JP (1997) Empiric trial of high dose omeprazole in patients with posterior laryngitis. Am J Gastroenterol 92:2160–2165

    PubMed  CAS  Google Scholar 

  12. Karkos PD, Leong SC, Potamianos SP (2007) Assessment of laryngopharyngeal reflux: facts. Surgeon 5:192 (author reply 192)

    Article  PubMed  CAS  Google Scholar 

  13. Papakonstantinou L, Leslie P, Gray J, Chadwick T, Hudson M, Wilson JA (2009) Laryngopharyngeal reflux: a prospective analysis of a 34 item symptom questionnaire. Clin Otolaryngol 34:455–459

    Article  PubMed  CAS  Google Scholar 

  14. Andersson O, Ryden A, Ruth M, Moller RY, Finizia C (2010) Development and validation of a laryngopharyngeal reflux questionnaire, the Pharyngeal Reflux Symptom Questionnaire. Scand J Gastroenterol 45:147–159

    Article  PubMed  Google Scholar 

  15. Reichel O, Dressel H, Wiederanders K, Issing WJ (2008) Double-blind, placebo-controlled trial with esomeprazole for symptoms and signs associated with laryngopharyngeal reflux. Otolaryngol Head Neck Surg 139:414–420

    Article  PubMed  Google Scholar 

  16. Barry DW, Vaezi MF Laryngopharyngeal reflux: more questions than answers. Cleve Clin J Med 77:327–334

  17. Karkos PD, Wilson JA (2006) Empiric treatment of laryngopharyngeal reflux with proton pump inhibitors: a systemic review. Laryngoscope 116:144–148

    Article  PubMed  CAS  Google Scholar 

  18. Vaezi MF, Richter JE, Stasney CR, Spiegel JR, Iannuzzi RA, Crawley JA, Hwang C, Sostek MB, Shaker R (2006) Treatment of chronic posterior laryngitis with esomeprazole. Laryngoscope 116:254–260

    Article  PubMed  CAS  Google Scholar 

  19. Kamel PL, Hanson D, Kahrilas PJ (1994) Prospective trial of omeprazole in the treatment of posterior laryngitis. Am J Med 96:321–326

    Article  PubMed  CAS  Google Scholar 

  20. So JB, Zeitels SM, Rattner DW (1998) Outcomes of atypical symptoms attributed to gastro-esophageal reflux treated by laparoscopic fundoplication. Surgery 124:28–32

    Article  PubMed  CAS  Google Scholar 

  21. El-Serag HB, Aguirre TV, Davis S, Kuebeler M, Bhattacharyya A, Sampliner RE (2004) Proton pump inhibitors are associated with reduced incidence of dysplasia in Barrett’s esophagus. Am J Gastroenterol 99:1877–1883

    Article  PubMed  CAS  Google Scholar 

  22. Steward DL, Wilson KM, Kelly DH, Patil MS, Schwartzbauer HR, Long JD, Welge JA (2004) Proton pump inhibitor therapy for chronic laryngo-pharyngitis: a randomized placebo-control trial. Otolaryngol Head Neck Surg 131:342–350

    Article  PubMed  Google Scholar 

  23. Johnson DA (2008) Medical therapy of reflux laryngitis. J Clin Gastroenterol 42:589–593

    Article  PubMed  Google Scholar 

  24. Cohen SM, Garrett CG (2008) Hoarseness: is it really laryngopharyngeal reflux? Laryngoscope 118:363–366

    Article  PubMed  Google Scholar 

  25. Adachi K, Hashimoto T, Hamamoto N, Hirakawa K, Niigaki M, Miyake T, Taniura H, Ono M, Kaji T, Suetsugu H, Yagi J, Komazawa Y, Mihara T, Katsube T, Fujishiro H, Shizuku T, Hattori S, Yamamoto S, Kinoshita Y (2003) Symptom relief in patients with reflux esophagitis: comparative study of omeprazole, lansoprazole, and rabeprazole. J Gastroenterol Hepatol 18:1392–1398

    Article  PubMed  CAS  Google Scholar 

  26. Thjodleifsson B (2004) Review of rabeprazole in the treatment of gastro-oesophageal reflux disease. Expert Opin Pharmacother 5:137–149

    Article  PubMed  CAS  Google Scholar 

  27. Park W, Hicks DM, Khandwala F, Richter JE, Abelson TI, Milstein C, Vaezi MF (2005) Laryngopharyngeal reflux: prospective cohort study evaluating optimal dose of proton-pump inhibitor therapy and pretherapy predictors of response. Laryngoscope 115:1230–1238

    Article  PubMed  CAS  Google Scholar 

  28. Reichel O, Keller J, Rasp G, Hagedorn H, Berghaus A (2007) Efficacy of once-daily esomeprazole treatment in patients with laryngopharyngeal reflux evaluated by 24-hour pH monitoring. Otolaryngol Head Neck Surg 136:205–210

    Article  PubMed  Google Scholar 

  29. Kinoshita Y, Ashida K, Hongo M (2010) Randomised clinical trial: a multicentre, double-blind, placebo controlled study on the efficacy and safety of rabeprazole 5 mg or 10 mg once daily in patients with non-erosive reflux disease. Aliment Pharmacol Ther. doi:10.1111/j.1365-2036.2010.04508.x (epub ahead of print)

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Acknowledgments

The authors are indebted to Sung-Cheol Yun, PhD, Department of Preventive Medicine, University of Ulsan, College of Medicine for statistical assistance. This study was supported by a grant from Janssen Korea. This company was not involved in writing this report.

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Authors and Affiliations

  1. Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine and Medical Research Institute, Pusan National University, Kyungnam, Korea

    Yoon Se Lee

  2. Department of Otolaryngology, Asan Medical Center, University of Ulsan, College of Medicine, 388-1, Pungnap2-dong, Songpa-gu, Seoul, 138-736, Korea

    Seung-Ho Choi, Sang Yoon Kim & Soon Yuhl Nam

  3. Department of Otorhinolaryngology-HNS, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea

    Young Ik Son

  4. Department of Otolaryngology-HNS, The Catholic University of Korea, School of Medicine, Seoul, Korea

    Young-Hak Park

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  1. Yoon Se Lee
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  2. Seung-Ho Choi
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Correspondence to Soon Yuhl Nam.

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Lee, Y.S., Choi, SH., Son, Y.I. et al. Prospective, observational study using rabeprazole in 455 patients with laryngopharyngeal reflux disease. Eur Arch Otorhinolaryngol 268, 863–869 (2011). https://doi.org/10.1007/s00405-010-1475-9

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  • DOI: https://doi.org/10.1007/s00405-010-1475-9

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