TITLE

Symptom Response and Healing of Erosive Esophagitis with Proton-Pump Inhibitors in Patients withHelicobacter pyloriInfection

AUTHOR(S)
Vakil, Nimish B.; Traxler, Barry M.; Levine, Douglas
PUB. DATE
August 2004
SOURCE
American Journal of Gastroenterology;Aug2004, Vol. 99 Issue 8, p1437
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
OBJECTIVES: The aim of this article is to determine the severity of esophagitis and the response to treatment with proton-pump inhibitors in patients with and without evidence ofHelicobacter pyloriinfection.METHODS: This retrospective analysis evaluated data collected in a randomized, double-blind clinical trial that assessed the efficacy and safety of once-daily esomeprazole 40 mg (n= 2,624)versuslansoprazole 30 mg (n= 2,617) for up to 8 wk in the treatment of reflux-associated erosive esophagitis. At baseline, erosive esophagitis was graded using the Los Angeles (LA) classification; serologic testing forH. pyloriwas performed using a FlexSure HP® serum test.RESULTS: There were 14.7% of patients who were seropositive forH. pylori. The percentages of seropositive and seronegative patients with each grade of esophagitis were: LA grade A, 38%, 36%; LA grade B, 41%, 39%; LA grade C, 16%, 19%; and LA grade D, 5%, 6%, respectively. Severe heartburn was present at baseline in 42% ofH. pylori-positive and 42% ofH. pylori-negative patients. Life-table healing rates with esomeprazole were not influenced byH. pyloristatus (seropositive 92.6% (95% confidence interval: 89.8–95.4); seronegative 92.6% (95% confidence interval: 91.4–93.7)). The rates with esomeprazole were significantly higher than those with lansoprazole (seropositive 90.5% (95% confidence interval: 87.5–93.5); seronegative 88.5% (95% confidence interval: 87.1–89.8)) after adjusting for baselineH. pyloristatus (p= 0.001).CONCLUSIONS: The severity of erosive esophagitis at baseline was similar regardless ofH. pyloriseropositivity. Healing rates were not influenced byH. pyloristatus.
ACCESSION #
14816401

 

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