Factors influencing treatment outcome in patients with gastroesophageal reflux disease: outcome of a prospective pragmatic trial in Asian patients

Khean Lee Goh, Kee Don Choi, Myung-Gyu Choi, Tsai-Yuan Hsieh, Hwoon-Yong Jung, Han-Chung Lien, Jayaram Menon, Steven Mesenas, Hyojin Park, Bor-Shyang Sheu, Justin Cy Wu, Khean Lee Goh, Kee Don Choi, Myung-Gyu Choi, Tsai-Yuan Hsieh, Hwoon-Yong Jung, Han-Chung Lien, Jayaram Menon, Steven Mesenas, Hyojin Park, Bor-Shyang Sheu, Justin Cy Wu

Abstract

Background: Predicting response to proton pump inhibitor (PPI) treatment can aid the effective management of gastroesophageal reflux disease (GERD). The aim was to investigate the predictors of symptomatic response to pantoprazole in Asian patients with GERD; the first study of its kind in Asian patients.

Methods: Asian patients with GERD symptoms (N = 209) received pantoprazole 40 mg daily for 8 weeks in a multinational, prospective, open-label study. Response was assessed using ReQuest™. Baseline and demographic factors were examined using logistic regression to determine if they were related to treatment response.

Results: Response rates were 44.3% (Week 4) and 63.6% (Week 8) in Asian patients versus 60.7% (P < 0.001) and 72.2% (P = 0.010) for the rest of the world. Higher response rates at 8 weeks occurred in patients with erosive reflux disease (ERD; 71.3%) versus those with non-erosive reflux disease (NERD) at baseline (48.5%). The presence of ERD (P = 0.0143) and lower ReQuest™-GI scores at baseline (P = 0.0222) were associated with response. Improvements in quality of life (QoL) and anxiety and depression at 4 and 8 weeks were associated with treatment response (both P < 0.0001). Patient satisfaction correlated with treatment response (P < 0.0001), and improvement in anxiety and depression (P < 0.0001) and QoL (P < 0.0001).

Conclusions: Asian patients with GERD, especially those with NERD, may have lower response rates to PPIs than Western populations. ERD and less severe gastrointestinal symptoms may help to predict symptomatic responses to PPIs in Asian patients.

Trial registration: ClinicalTrial.gov identifier: NCT00312806.

Figures

Figure 1
Figure 1
Percentage of patients responding to pantoprazole 40 mg once daily at Week 4 and Week 8 of treatment. A comparison of Asian populations (combined: Hong Kong, Korea, Malaysia, Singapore and Taiwan) with the rest of the world.
Figure 2
Figure 2
Improvement in quality of life (total GERDyzerTMscore) by patient response to treatment (assessed using ReQuestTM-GI). A comparison of Asian populations (combined: Hong Kong, Korea, Malaysia, Singapore and Taiwan) with the rest of the world.
Figure 3
Figure 3
Improvement in anxiety and depression (HADS score) by patient response to treatment (assessed using ReQuestTM-GI). A comparison of Asian populations (combined: Hong Kong, Korea, Malaysia, Singapore and Taiwan) with the rest of the world.
Figure 4
Figure 4
Proportion of responders versus non-responders satisfied with symptom control in the preceding 24 hours. A comparison of Asian populations (combined: Hong Kong, Korea, Malaysia, Singapore and Taiwan) with the rest of the world.

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Pre-publication history
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