Background. Proton pump inhibitors (PPIs) are currently the reference drugs for gastroesophageal reflux disease (GERD), but symptoms often recur after their withdrawal. Moreover, whether prokinetics orbarrier drugs used alongside PPIs are more effective remains under debate. Objectives. The aim of the study was to assess the efficacy of different therapeutic approaches to GERD treatment. Materials and methods. Weenrolled 211grade A reflux esophagitis patients who consented toparticipate inthis non-randomized, open-label trial. Thestudy consisted of6sequentially administered medical treatments for GERD, lasting 2 months, with a3-week washout period between each drug schedule: Group A: PPI (esomeprazole 40 mg/day before breakfast); Group B: mucosal protective drugs (acombination ofhyaluronic acid, chondroitin sulfate and poloxamer 407, oracombination ofhyaluronic acid, chondroitin sulfate and aluminum, 3times daily after a meal); Group C: prokinetics (levosulpiride 25 mg ordomperidone 10 mg, 3times daily before a meal); Group D: barrier drug (alginate 3times daily after a meal); Group E: PPI (esomeprazole 40 mg/day before breakfast) and mucosal protective drugs (a combination ofhyaluronic acid, chondroitin sulfate and poloxamer 407, ora combination ofhyaluronic acid, chondroitin sulfate and aluminum, before sleep); Group F: PPI (esomeprazole 40mg/day before breakfast) and prokinetics (levosulpiride 25mg ordomperidone 10 mg before lunch and dinner). Symptoms were evaluated using thevisual analogue scale (VAS) and global symptomatic score (GSS), asfollows: heartburn: 0–3; retrosternal chest pain: 0–3; regurgitation: 0–3. Results. All but 2treatments (groups Cand D) significantly improved VAS and GSS, with group Eshowing themost significant GSS improvement. Group Chad thehighest number ofdropouts due totreatment failure and reported more side effects. Conclusions. Using PPIs and mucosal protective drugs resulted in insignificant symptom alleviation. However, the administration of prokinetics caused higher dropouts due to treatment failure
A comparison of different symptomatic reflux esophagitis treatments: A real-world study / DI MARIO, Francesco; Crafa, Pellegrino; Franzoni, Lorella; Tursi, Antonio; Brandimarte, Giovanni; Russo, Michele; Rodriguez-Castro Kryssia, Isabel; Franceschi, Marilisa; De Bortoli, Nicola; Savarino, Edoardo. - In: ADVANCES IN CLINICAL AND EXPERIMENTAL MEDICINE. - ISSN 1899-5276. - (2023), pp. 1075-1080. [10.17219/acem/171001]
A comparison of different symptomatic reflux esophagitis treatments: A real-world study
Di Mario FrancescoWriting – Review & Editing
;Crafa Pellegrino
Writing – Review & Editing
;Franzoni LorellaWriting – Review & Editing
;Russo MicheleMembro del Collaboration Group
;
2023-01-01
Abstract
Background. Proton pump inhibitors (PPIs) are currently the reference drugs for gastroesophageal reflux disease (GERD), but symptoms often recur after their withdrawal. Moreover, whether prokinetics orbarrier drugs used alongside PPIs are more effective remains under debate. Objectives. The aim of the study was to assess the efficacy of different therapeutic approaches to GERD treatment. Materials and methods. Weenrolled 211grade A reflux esophagitis patients who consented toparticipate inthis non-randomized, open-label trial. Thestudy consisted of6sequentially administered medical treatments for GERD, lasting 2 months, with a3-week washout period between each drug schedule: Group A: PPI (esomeprazole 40 mg/day before breakfast); Group B: mucosal protective drugs (acombination ofhyaluronic acid, chondroitin sulfate and poloxamer 407, oracombination ofhyaluronic acid, chondroitin sulfate and aluminum, 3times daily after a meal); Group C: prokinetics (levosulpiride 25 mg ordomperidone 10 mg, 3times daily before a meal); Group D: barrier drug (alginate 3times daily after a meal); Group E: PPI (esomeprazole 40 mg/day before breakfast) and mucosal protective drugs (a combination ofhyaluronic acid, chondroitin sulfate and poloxamer 407, ora combination ofhyaluronic acid, chondroitin sulfate and aluminum, before sleep); Group F: PPI (esomeprazole 40mg/day before breakfast) and prokinetics (levosulpiride 25mg ordomperidone 10 mg before lunch and dinner). Symptoms were evaluated using thevisual analogue scale (VAS) and global symptomatic score (GSS), asfollows: heartburn: 0–3; retrosternal chest pain: 0–3; regurgitation: 0–3. Results. All but 2treatments (groups Cand D) significantly improved VAS and GSS, with group Eshowing themost significant GSS improvement. Group Chad thehighest number ofdropouts due totreatment failure and reported more side effects. Conclusions. Using PPIs and mucosal protective drugs resulted in insignificant symptom alleviation. However, the administration of prokinetics caused higher dropouts due to treatment failureI documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
