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Daily treatment with esomeprazole is superior to that taken on demand for maintenance of healed erosive esophagitis

Sjöstedt, S; Befrits, R; Sylvan, A; Carling, L; Harthon, C; Modin, S; Stubberöd, A and Toth, Ervin LU (2005) In Alimentary Pharmacology & Therapeutics 22(3). p.183-191
Abstract
Background: On-demand therapy with esomeprazole is effective for long-term treatment of non-erosive gastro-oesophageal reflux disease, but it has not been evaluated in erosive gastro-oesophageal reflux disease. Aims: To compare endoscopic and symptomatic remission over a 6-month period when patients with healed erosive gastro-oesophageal reflux disease are treated with esomeprazole 20 mg, either once daily or on-demand. Methods: Patients with verified erosive reflux oesophagitis of Los Angeles grades A-D were enrolled. Following 4-8 weeks treatment with esomeprazole 40 mg daily, those who were endoscopically healed and had symptom control during the last week were randomized to maintenance therapy for 6 months with esomeprazole 20 mg,... (More)
Background: On-demand therapy with esomeprazole is effective for long-term treatment of non-erosive gastro-oesophageal reflux disease, but it has not been evaluated in erosive gastro-oesophageal reflux disease. Aims: To compare endoscopic and symptomatic remission over a 6-month period when patients with healed erosive gastro-oesophageal reflux disease are treated with esomeprazole 20 mg, either once daily or on-demand. Methods: Patients with verified erosive reflux oesophagitis of Los Angeles grades A-D were enrolled. Following 4-8 weeks treatment with esomeprazole 40 mg daily, those who were endoscopically healed and had symptom control during the last week were randomized to maintenance therapy for 6 months with esomeprazole 20 mg, taken either once daily or on-demand. Results: Of 539 enrolled patients, 494 (91%) were healed at 8 weeks and 477 were randomized to maintenance therapy with esomeprazole 20 mg, 243 once daily and 234 on-demand. After once daily treatment, 81% of patients were still in remission at 6 months, compared with only 58% who took on-demand treatment (P < 0.0001). A difference in remission was found irrespective of baseline grade of oesophagitis, but it was more pronounced for the more severe grades. There was no difference in overall symptomatic remission between the two treatments, although heartburn was significantly more prevalent in the on-demand group. Conclusions: Once daily esomeprazole 20 mg was better than that taken on-demand for maintaining healed erosive oesophagitis, regardless of baseline Los Angeles grade. (Less)
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author
publishing date
type
Contribution to journal
publication status
published
subject
in
Alimentary Pharmacology & Therapeutics
volume
22
issue
3
pages
183 - 191
publisher
Wiley-Blackwell
external identifiers
  • WOS:000230886800003
  • Scopus:23844557524
ISSN
0269-2813
DOI
10.1111/j.1365-2036.2005.02553.x
language
English
LU publication?
no
id
2804c9c3-a6ad-4b99-95ce-95fa755310b7 (old id 592520)
date added to LUP
2009-06-04 16:22:09
date last changed
2016-10-13 04:32:00
@misc{2804c9c3-a6ad-4b99-95ce-95fa755310b7,
  abstract     = {Background: On-demand therapy with esomeprazole is effective for long-term treatment of non-erosive gastro-oesophageal reflux disease, but it has not been evaluated in erosive gastro-oesophageal reflux disease. Aims: To compare endoscopic and symptomatic remission over a 6-month period when patients with healed erosive gastro-oesophageal reflux disease are treated with esomeprazole 20 mg, either once daily or on-demand. Methods: Patients with verified erosive reflux oesophagitis of Los Angeles grades A-D were enrolled. Following 4-8 weeks treatment with esomeprazole 40 mg daily, those who were endoscopically healed and had symptom control during the last week were randomized to maintenance therapy for 6 months with esomeprazole 20 mg, taken either once daily or on-demand. Results: Of 539 enrolled patients, 494 (91%) were healed at 8 weeks and 477 were randomized to maintenance therapy with esomeprazole 20 mg, 243 once daily and 234 on-demand. After once daily treatment, 81% of patients were still in remission at 6 months, compared with only 58% who took on-demand treatment (P &lt; 0.0001). A difference in remission was found irrespective of baseline grade of oesophagitis, but it was more pronounced for the more severe grades. There was no difference in overall symptomatic remission between the two treatments, although heartburn was significantly more prevalent in the on-demand group. Conclusions: Once daily esomeprazole 20 mg was better than that taken on-demand for maintaining healed erosive oesophagitis, regardless of baseline Los Angeles grade.},
  author       = {Sjöstedt, S and Befrits, R and Sylvan, A and Carling, L and Harthon, C and Modin, S and Stubberöd, A and Toth, Ervin},
  issn         = {0269-2813},
  language     = {eng},
  number       = {3},
  pages        = {183--191},
  publisher    = {ARRAY(0x69b0a08)},
  series       = {Alimentary Pharmacology & Therapeutics},
  title        = {Daily treatment with esomeprazole is superior to that taken on demand for maintenance of healed erosive esophagitis},
  url          = {http://dx.doi.org/10.1111/j.1365-2036.2005.02553.x},
  volume       = {22},
  year         = {2005},
}