| Title | Comparison of one-week and two-week empirical trial with a high-dose rabeprazole in non-cardiac chest pain patients. | | Author(s) | Kim JH, Sinn DH, Son HJ, Kim JJ, Rhee JC, Rhee PL | | Institution | Department of Internal Medicine, Konkuk University School of Medicine, School of Medicine, Seoul, Korea. | | Source | J Gastroenterol Hepatol 2009 Sep; 24(9):1504-9. | | MeSH | 2-Pyridinylmethylsulfinylbenzimidazoles
Adult
Aged
Chest Pain
Drug Administration Schedule
Empirical Research
Endoscopy, Digestive System
Esophageal pH Monitoring
Female
Gastroesophageal Reflux
Humans
Male
Middle Aged
Predictive Value of Tests
Proton Pump Inhibitors
Research Design
Sensitivity and Specificity
Severity of Illness Index
Time Factors
Treatment Outcome
| | Abstract | BACKGROUND: In patients with non-cardiac chest pain (NCCP), the optimal duration of an empirical trial with a high-dose proton pump inhibitor (PPI) is unclear. We aimed to compare the efficacy of one-week and two-week PPI trial in patients with weekly or more than weekly NCCP and to determine its optimal duration for diagnosing gastroesophageal reflux disease (GERD)-related NCCP.
METHODS: Forty-two patients with at least weekly NCCP were enrolled. The baseline symptoms were assessed using a daily symptom diary for seven days. Also, esophago-gastro-duodenoscopy and 24 h esophageal pH monitoring were performed for the diagnosis of GERD. Then, patients were treated with rabeprazole 20 mg twice daily for 14 days. To assess NCCP improvement during the PPI trial, the first week and the second week symptom diary were kept for 1-7 and 8-14 days. The PPI test was considered positive if a symptom score improved (50% compared to the baseline.
RESULTS: There was no significant difference for a positive PPI test between GERD-related NCCP group (n = 8, 50%) and non GERD-related NCCP group (n = 6, 23%) during the first week of the PPI test. However, during the second week, GERD-related NCCP had a higher positive PPI test (n = 13, 81%) than non GERD-related NCCP (n = 7, 27%) (P = 0.001) with a sensitivity and specificity of 81% and 62%, respectively.
CONCLUSIONS: The rabeprazole empirical trial was diagnostic for patients with GERD-related NCCP, and its optimal duration was determined to be at least two weeks. | | Language | eng | | Pub Type(s) | Clinical Trial
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
| | PubMed ID | 19467139 |
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