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TY - JOUR
JO - Advances in Clinical and Experimental Medicine
J2 - Adv Clin Exp Med
SN - 1899-5276
PB - Wroclaw Medical University
VL - 32
IS - 9
PY - 2023
ID - Mario2023-09-28
TI - A comparison of different symptomatic reflux esophagitis treatments: A real-world study
AB - 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 or barrier 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.Material and Methods. We enrolled 211 grade A reflux esophagitis patients who consented to participate in this non-randomized, open-label trial. The study consisted of 6 sequentially administered medical treatments for GERD, lasting 2 months, with a 3-week washout period between each drug schedule: Group A: PPI (esomeprazole 40 mg/day before breakfast); Group B: mucosal protective drugs (a combination of hyaluronic acid, chondroitin sulfate and poloxamer 407, or a combination of hyaluronic acid, chondroitin sulfate and aluminum, 3 times daily after a meal); Group C: prokinetics (levosulpiride 25 mg or domperidone 10 mg, 3 times daily before a meal); Group D: barrier drug (alginate 3 times daily after a meal); Group E: PPI (esomeprazole 40 mg/day before breakfast) and mucosal protective drugs (a combination of hyaluronic acid, chondroitin sulfate and poloxamer 407, or a combination of hyaluronic acid, chondroitin sulfate and aluminum, before sleep); Group F: PPI (esomeprazole 40 mg/day before breakfast) and prokinetics (levosulpiride 25 mg or domperidone 10 mg before lunch and dinner). Symptoms were evaluated using the visual analogue scale (VAS) and global symptomatic score (GSS), as follows: heartburn: 0–3; retrosternal chest pain: 0–3; regurgitation: 0–3.Results. All but 2 treatments (groups C and D) significantly improved VAS and GSS, with group E showing the most significant GSS improvement. Group C had the highest number of dropouts due to treatment failure and reported more side effects.Conclusion. Using PPIs and mucosal protective drugs resulted in significant symptom alleviation. However, the administration of prokinetics caused higher dropouts due to treatment failure.
AU - Mario, Francesco Di
AU - Crafa, Pellegrino
AU - Franzoni, Lorella
AU - Tursi, Antonio
AU - Brandimarte, Giovanni
AU - Russo, Michele
AU - Rodriguez-Castro, Kryssia Isabel
AU - Franceschi, Marilisa
AU - Bortoli, Nicola De
AU - Savarino, Edoardo
SP - 1075
EP - 1080
DA - 2023-09-28
DO - 10.17219/acem/171001
UR - http://dx.doi.org/10.17219/acem/171001
ER -