Treatment Duration and Clinical Response Patterns of Laryngopharyngeal Reflux Disease

OBJECTIVE: To investigate the therapeutic response patterns in terms of duration, resistance, and therapeutic failure in patients with a confirmed LPRD diagnosis. STUDY DESIGN: Prospective study. SETTING: University hospital. METHODS: Patients with laryngopharyngeal symptoms and >1 pharyngeal reflux event on 24-h hypopharyngeal-esophageal impedance-pH monitoring were prospectively recruited (European Reflux Clinic, Jan 2017-Oct 2025). Based on LPRD pattern, they received diet/lifestyle measures plus alginate, magaldrate and/or PPIs in successive 3-month courses until significant symptom relief allowed discontinuation. Outcomes (RSS, RSA) and optimal treatment duration, success/weaning rates, and chronicity were assessed. RESULTS: A total of 361 consecutive patients completed the evaluations (214 females, 59.3%), with 135 (37.4%), 87 (24.1%), and 139 (38.5%) presenting mild, moderate, and severe reflux disease (IFOS classification), respectively. Of 304 patients with complete follow-up, 105 (34.5%) achieved complete response, occurring primarily at 6 weeks (27.6%), 3 months (42.9%), and 6 months (21.9%) posttreatment; 93/105 (88.6%) remained symptom-free after discontinuation. Symptoms stabilized in 148/304 (48.7%) patients continuing diet and lifestyle modifications with/without medication. Fluctuating relief and chronic course occurred in 21/304 (6.9%) and 30/304 (9.9%) despite drug class changes. Binary logistic regression revealed baseline IFOS classification as a significant predictor of complete response (P = .038, OR = 1.518, 95% CI [1.024-2.251]). CONCLUSION: Several LPRD patterns were identified: 34.5% achieved complete remission, 48.7% showed sustained symptom reduction, and 16.8% had fluctuating/chronic symptoms despite drug class changes. Baseline IFOS score predicts therapeutic trajectory and outcomes.