Key result
Patients with erosive oesophagitis had a lower rate of refractory symptoms to PPI therapy at 8 weeks compared to patients with non-erosive reflux disease.
Why the study?
Does the clinical response to proton pump inhibitors and risk factors differ between patients with erosive oesophagitis and non-erosive reflux disease?
Cohort (n=405)
Does the clinical response to proton pump inhibitors and risk factors differ between patients with erosive oesophagitis and non-erosive reflux disease?
Answers are grounded in this paper and cite their sources.
Patients with non-erosive reflux disease have higher refractory rates to PPI therapy at 8 weeks compared to those with erosive oesophagitis, suggesting distinct underlying pathogenic mechanisms.
BACKGROUND: There has been no report on the response to proton pump inhibitor (PPI) therapy and on-demand or the relapse rate of non-erosive reflux disease (NERD) and erosive oesophagitis in Korea. AIM: To compare the risk factors, clinical symptoms and PPI responses between patients with erosive oesophagitis and NERD patients. METHODS: A survey was performed prospectively in the erosive oesophagitis (205 patients) and NERD group (200 patients). Clinical symptoms, risk factors and PPI responses were analysed. On-demand therapy and the relapse rate of GERD symptoms were investigated during a one-year follow-up. RESULTS: BMI > or = 25 (OR 3.0, 95% CI 1.1-8.3), alcohol use (OR 2.9, 95% CI 1.0-8.3), hiatal hernia (OR 5.0, 95% CI 1.2-20) and triglyceride > or =150 mg/dL (OR 4.0, 95% CI 1.7-10) were more common in the erosive oesophagitis group than in the NERD group by multivariate analysis. The ratio of oesophageal to extra-oesophageal symptoms was higher in the erosive oesophagitis group compared with the NERD group (P < 0.001). The PPI response rates at 8 weeks were different (P = 0.02); refractory rates were higher in the NERD group (16.7%) compared with the erosive oesophagitis group (6.0%). However, there was no significant difference between the two groups in on-demand therapy or the relapse rate. CONCLUSION: These results suggest that the underlying pathogenic mechanisms of erosive oesophagitis and NERD are distinct.
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Lee et al. (2009) conducted a cohort in Erosive oesophagitis and non-erosive reflux disease (NERD) (n=405). Erosive oesophagitis vs. Non-erosive reflux disease (NERD) was evaluated on PPI refractory rate at 8 weeks (p=0.02). Patients with erosive oesophagitis had a lower rate of refractory symptoms to PPI therapy at 8 weeks compared to patients with non-erosive reflux disease.
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