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Proton-pump inhibitors also effective in nonerosive reflux disease. (Accounts for 50%-70% of Gerd Cases).

SEATTLE--Proton-pump inhibitors, the therapeutic mainstay for gastroesophageal reflux disease, are also highly effective in the treatment of nonerosive reflux disease, according to a new metaanalysis.

That's good news, since nonerosive reflux disease (NERD) accounts for an estimated 50%-70% of total cases of gastroesophageal reflux disease (GERD). Prior to the metaanalysis, there wasn't really persuasive evidence that proton-pump inhibitors (PPIs) are effective in NERD. The great majority of data supporting PPI therapy in GERD come from clinical trials restricted to the minority of GERD patients having endoscopic evidence of erosive esophagitis, Dr. Ronnie Pass said at the annual meeting of the American College of Gastroenterology.

Indeed, after reviewing 107 studies on PPI therapy published or presented in abstract form since 1985, the investigators determined that only 6 randomized trials and 4 Food and Drug Administration reports met their criteria for inclusion in the metaanalysis, namely 4-week heartburn resolution data in patients with negative endoscopy or with endoscopic findings of erythema and friability but no erosions. The analysis included roughly 3,000 patients, said Dr. Pass of the University of Arizona, Tucson.

At 4 weeks, the rate of sufficient heartburn control--an end point defined as less than 1 day of moderate heartburn during the last 7 days of treatment--was 5 6.6% in PPI-treated patients and 22.9% in those randomized to placebo. For the more stringent end point of complete heartburn control, defined as no heartburn during the last 7 days of treatment, the rate was 36.6% with PPI therapy and 9.6% with placebo.
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Author:Jancin, Bruce
Publication:OB GYN News
Date:Jul 1, 2003
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