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Comparison of the efficiency of two different proton pump inhibitor formula in treatment of patients with atypical gastroesophageal reflux disease: a prospective randomized study
Author(s) -
Lin XiHsuan,
Luo JiingChyuan,
Ting PoHsiang,
Chang TienEn,
Huang YiHsiang,
Hou MingChih,
Lee FaYauh
Publication year - 2020
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.15093
Subject(s) - lansoprazole , gerd , medicine , proton pump inhibitor , gastroenterology , reflux , heartburn , nerd , esomeprazole , disease , helicobacter pylori
Background and Aim The prospective, open‐label, randomized study aims to compare the efficacy of lansoprazole, a fast orally disintegrating proton pump inhibitor (PPI), and dexlansoprazole, a dual delayed release PPI, in patients with atypical symptoms of gastroesophageal reflux disease (GERD). Methods Patients with atypical GERD symptoms with a total reflux symptom index score > 10 were eligible for enrollment. From February 2018 to December 2019, 232 subjects were randomly assigned (1:1 ratio) to receive oral lansoprazole, Takepron OD 30 mg, once daily before breakfast or oral dexlansoprazole, Dexilant 60 mg, once daily before breakfast for 8 weeks. The primary end‐point is to compare the symptoms response rate after an 8‐week PPI therapy between the two groups. Results There were 232 study subjects enrolling in this study. After the 8‐week PPI therapy, dexlansoprazole‐treated group had a significantly higher response rate than lansoprazole‐treated group in cough (76.5% vs 38.0%) and globus (69.7% vs 30.8%) ( P all < 0.05 by intention‐to‐treat). Multivariate logistic regression analysis showed that the use of dexlansoprazole, presence of dyslipidemia, and typical GERD symptoms (acid reflux and heartburn) were predictors for symptom response for cough; the use of dexlansoprazole and presence of erosive esophagitis were predictors for symptom response for globus ( P all < 0.05). No predictor for therapy response to hoarseness was noted. Conclusions There is a higher response rate for cough and globus symptoms in patients with atypical GERD after the 8‐week PPI therapy with dexlansoprazole rather than lansoprazole.