TITLE

Management Strategy for Patients With Gastroesophageal Reflux Disease: A Comparison Between Empirical Treatment With Esomeprazole and Endoscopy-Oriented Treatment

AUTHOR(S)
Giannini, Edoardo G.; Zentilin, Patrizia; Dulbecco, Pietro; Vigneri, Sergio; Scarlata, Pamela; Savarino, Vincenzo
PUB. DATE
February 2008
SOURCE
American Journal of Gastroenterology;Feb2008, Vol. 103 Issue 2, p267
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
OBJECTIVES: Whether patients with typical gastroesophageal reflux disease (GERD) symptoms and without alarm features should be treated empirically or undergo endoscopy first is a debated issue. In this study, our aim was to assess the efficacy, and to compare the direct costs and impact on health-related quality of life (HRQL), of two treatment strategies (empirical vs endoscopy-oriented treatment) in a large population of patients with GERD. METHODS: In total, 612 patients were randomized to either empirical treatment with esomeprazole 40 mg once daily (od) (group 1, N = 309) or endoscopy and treatment according to endoscopic findings (group 2, N = 303, esomeprazole 40 mg od in patients with reflux esophagitis and esomeprazole 20 mg od in patients without esophagitis) for 4 wk, followed by esomeprazole 20 mg od maintenance treatment in both groups. Direct costs and HRQL were analyzed in both treatment arms. RESULTS: At the end of the acute treatment phase (week 4), 267 patients in group 1 (86.4%) and 265 patients in group 2 (87.5%) were considered responders to treatment (intention-to-treat analysis, P= 0.878). Empirical treatment proved to be cost-effective by saving 38.72 euros per treated patient. At the end of the maintenance phase (week 24), a similar proportion of patients responded to treatment in the two groups (71.8% vs 68.3%, P= 0.389). HRQL improved from baseline to week 24 in both groups (difference between study groups not significant). CONCLUSIONS: In patients with GERD, empirical treatment with esomeprazole proved to be cost-effective compared with endoscopy-oriented treatment, and did not negatively affect patient HRQL. These results should be taken into account in the management of GERD patients in clinical practice.
ACCESSION #
29383641

 

Related Articles

  • The influence of demographic factors and health-related quality of life on treatment satisfaction in patients with gastroesophageal reflux disease treated with esomeprazole. Innocenti, Alessio Degl'; Guyatt, Gordon H.; Wiklund, Ingela; Heels-Ansdell, Diane; Armstrong, David; Fallone, Carlo A.; Tanser, Lisa; Van Zanten, Sander Veldhuyzen; El-Dika, Samer; Chiba, Naoki; Barkun, Alan N.; Austin, Peggy; Schünemann, Holger J. // Health & Quality of Life Outcomes;2005, Vol. 3, p4 

    Background: The correlation between treatment satisfaction and demographic characteristics, symptoms, or healthrelated quality of life (HRQL) in patients with gastroesophageal reflux disease (GERD) is unknown. The objective of this study was to assess correlates of treatment satisfaction in...

  • Cost-Effectiveness Model of Endoscopic Biopsy for Eosinophilic Esophagitis in Patients With Refractory GERD. Miller, Stephen M.; Goldstein, Jay L.; Gerson, Lauren B. // American Journal of Gastroenterology;Aug2011, Vol. 106 Issue 8, p1439 

    OBJECTIVES:The population prevalence of eosinophilic esophagitis (EoE) is ∼7% in adults. Current American Gastroenterology Association guidelines recommend endoscopic biopsy (Bx) in patients with symptoms of dysphagia. We conducted a cost-effectiveness model to determine if endoscopic Bx is...

  • Quality of Life and Patient Satisfaction 3 Months and 3 Years After Laparoscopic Nissen's Fundoplication. Hamdy, Emad; El-Raouf, Ahmed Abd; El-Hemaly, Mohamed; Salah, Tarek; El-Hanafy, Ehab; Mostafa, Mohamed; Hak, Nabil GadEl // Saudi Journal of Gastroenterology;Jan-Mar2008, Vol. 14 Issue 1, p24 

    Background/Aim: This study is based on studying the quality of life and degree of satisfaction among gastroesophageal reflux disease (GERD) patients after Laparoscopic Nissen's fundoplication (LNF) operations. Summary Background Data: A GERD patient is most interested in symptom relief, whereas...

  • Symptom severity and oesophageal chemosensitivity to acid in order and young patients with gastro-oesophageal reflux. Fass, Ronnie; Pulliam, Gloria // Age & Ageing;Mar2000, Vol. 29 Issue 2, p125 

    Presents information on a study which compared the extent of esophageal mucosal injury, acid exposure, symptom severity and perception thresholds for acid infusion in older and younger patients with gastro-esophageal reflux. Methods used in the study; Results; Factors contributing to a...

  • 'Iceberg' cyst of the right vocal fold. Apicella, Sheila; Rosen, Clark A. // ENT: Ear, Nose & Throat Journal;Jan2002, Vol. 81 Issue 1, p12 

    Focuses on a patient with a history of gastroesphageal reflux disease and cholecystitis with dysphonia of 1 year's duration. Findings on laryngovideostroboscopy; Treatment given to the patient.

  • Manometric findings in patients with isolated distal gastroesophageal reflux. Ozin, Yasemin; Dagli, Ulku; Kuran, Sedef; Sahin, Burhan; Fisichella, Marco // World Journal of Gastroenterology;11/21/2009, Vol. 15 Issue 43, p5461 

    AIM: To analyze manometric abnormalities in patients with isolated distal reflux and compare these findings in patients with erosive and non-erosive disease. METHODS: Five hundred and fifty patients who presented to the outpatient clinic of Turkiye Yuksek Ihtisas Hospital with gastroesophageal...

  • Patient reported outcomes in gastroesophageal reflux disease: an overview of available measures. Talley, Nicholas J.; Wiklund, Ingela // Quality of Life Research;Feb2005, Vol. 14 Issue 1, p21 

    Gastroesophageal reflux disease (GERD) is a common, chronic disorder. The main symptom of GERD is heartburn, although a diverse range of symptoms can be associated with the disease including acid regurgitation and epigastric pain. GERD is also a risk factor for Barrett's oesophagus and...

  • Psychological Distress in Patients with Gastroesophageal Reflux Disease. Baker, Laurence H.; Lieberman, David; Oehlke, Megan // American Journal of Gastroenterology;Oct1995, Vol. 90 Issue 10, p1797 

    Background: Psychological factors play a role in a variety of gastrointestinal illnesses, including esophageal diseases. The role of psychological factors in gastroesophageal reflux disease (GERD) is not known. The purpose of this study was to determine if psychological distress is present in...

  • Laparoscopic Nissen fundoplication combined with posterior gastropexy in surgical treatment of GERD. Tsimogiannis, Konstantinos E.; Pappas-Gogos, George K.; Benetatos, Nikolaos; Tsironis, Demitrios; Farantos, Charalampos; Tsimoyiannis, Evangelos C. // Surgical Endoscopy;Jun2010, Vol. 24 Issue 6, p1303 

    Laparoscopic Nissen fundoplication (LNF) has become established as the procedure of choice in the surgical management of the majority of patients suffering from gastroesophageal reflux disease (GERD). Postoperative paraesophageal herniation has an incidence range up to 7% in the immediate...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics