Predictors of either rapid healing or refractory reflux oesophagitis during treatment with potent acid suppression. Issue 6 (15th July 2014)

• Record Type: Journal Article
• Authors: Kahrilas, P. J.; Persson, T.; Denison, H.; Wernersson, B.; Hughes, N.; Howden, C. W.
• Is Part Of: Alimentary pharmacology & therapeutics. Volume 40:Issue 6(2014)
• Page Start: 648
• Page End: 656
• Publication Date: 2014-07-15
• Subjects: Digestive organs -- Diseases -- Treatment -- Periodicals; Digestive organs -- Effect of drugs on -- Periodicals; Gastrointestinal system -- Diseases -- Treatment -- Periodicals; Gastrointestinal system -- Effect of drugs on -- Periodicals; 615.73
• DOI: 10.1111/apt.12877
• Languages: English
• ISSNs: 0269-2813

Abstract

<abstract abstract-type="main" id="apt12877-abs-0001"> <title>Summary</title> <sec id="apt12877-sec-0001" sec-type="section"> <title>Background</title> <p>Little is known regarding patient characteristics that influence the speed of reflux oesophagitis (RO) healing.</p> </sec> <sec id="apt12877-sec-0002" sec-type="section"> <title>Aim</title> <p>To investigate patient characteristics that may influence RO healing rates.</p> </sec> <sec id="apt12877-sec-0003" sec-type="section"> <title>Methods</title> <p>A <italic>post hoc</italic> analysis of clinical trial data for potent acid suppression treatment of RO (esomeprazole <italic>or </italic>AZD0865) was conducted. Group A underwent endoscopy at baseline, week 2 and 4, and group B at baseline, week 4 and 8. Group A patients were sub‐grouped as 'rapid' (healed at 2 weeks) or unhealed at 2 weeks. Group B patients were sub‐grouped as 'slow' (healed at 8 weeks, not at 4 weeks) or 'refractory' (not healed at 8 weeks). Logistic regression analysis was performed only for comparisons within group A.</p> </sec> <sec id="apt12877-sec-0004" sec-type="section"> <title>Results</title> <p>At 2, 4 and 8 weeks, RO had healed in 68%, 65% and 61% of patients unhealed at previous endoscopy, respectively. Low‐grade [vs. high‐grade (C or D)] RO was the only independent predictor of rapid healing in group A after logistic regression analysis. Significantly more rapid healers had low grade RO (A or B) at baseline than patients with refractory RO (84% vs. 49%; <italic>P </italic><<italic> </italic>0.001), and significantly more refractory patients had frequent regurgitation at baseline than slow healers (80% vs. 63%; <italic>P </italic>=<italic> </italic>0.039).</p> </sec> <sec id="apt12877-sec-0005" sec-type="section"> <title>Conclusions</title> <p>Low‐ (vs. high‐) grade RO determines the most rapid benefit from acid suppression. Roughly two‐thirds of patients healed with each time increment of potent acid suppression therapy. This suggests that some unhealed patients may still heal with continued therapy and that truly refractory RO is rare. (ClinicalTrials.gov: NCT00206245).</p> </sec> </abstract>