Prediction of response to PPI therapy and factors influencing treatment outcome in patients with GORD: a prospective pragmatic trial using pantoprazole

• Published in: BMC gastroenterology Vol. 11; no. 1; p. 52
• Main Authors: Heading, Robert C, Mönnikes, Hubert, Tholen, Anne, Schmitt, Holger
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 11.05.2011; BioMed Central; BMC
• Subjects: 2-Pyridinylmethylsulfinylbenzimidazoles - adverse effects; 2-Pyridinylmethylsulfinylbenzimidazoles - therapeutic use; Adult; Anxiety; Body Mass Index; Dosage and administration; Drug therapy; Female; Gastroesophageal reflux; Gastroesophageal Reflux - drug therapy; Gastroesophageal Reflux - pathology; Humans; Irritable Bowel Syndrome; Logistic Models; Male; Middle Aged; Pantoprazole; Patient outcomes; Patient Satisfaction; Proton Pump Inhibitors - adverse effects; Proton Pump Inhibitors - therapeutic use; Quality of Life; Sex Factors; Surveys and Questionnaires; Treatment Outcome; United Kingdom; Switzerland; Germany
• DOI: 10.1186/1471-230X-11-52
• ISSN: 1471-230X

Management of patients with gastro-oesophageal reflux disease (GORD) can be assisted by information predicting the likely response to proton pump inhibitor (PPI) treatment. The aim was to undertake a study of GORD patients designed to approximate ordinary clinical practice that would identify patient characteristics predicting symptomatic response to pantoprazole treatment. 1888 patients with symptoms of GORD were enrolled in a multicentre, multinational, prospective, open study of 8 weeks pantoprazole treatment, 40 mg daily. Response was assessed by using the ReQuest™ questionnaire, by the investigator making conventional clinical enquiry and by asking patients about their satisfaction with symptom control. Factors including pre-treatment oesophagitis, gender, age, body mass index (BMI), Helicobacter pylori status, anxiety and depression, and concurrent IBS symptoms were examined using logistic regression to determine if they were related to response, judged from the ReQuest™-GI score. Poorer treatment responses were associated with non-erosive reflux disease, female gender, lower BMI, anxiety and concurrent irritable bowel syndrome symptoms before treatment. No association was found with age, Helicobacter pylori status or oesophagitis grade. Some reflux-related symptoms were still present in 14% of patients who declared themselves 'well-satisfied' with their symptom control. Some readily identifiable features help to predict symptomatic responses to a PPI and consequently may help in managing patient expectation. ClinicalTrial.gov identifier: NCT00312806.