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Risk factors for relapse of erosive GERD during long-term maintenance treatment with proton pump inhibitor: a prospective multicenter study in Japan.
J Gastroenterol 2010; 45(12):1193-200JG

Abstract

BACKGROUND

Despite low gastric acid secretion levels among elderly people and Helicobacter pylori-positive individuals in Japan, many patients suffer from endoscopic relapse of erosive gastroesophageal reflux disease (GERD) during standard-dose proton pump inhibitor (PPI) maintenance therapy. We aimed to investigate the relapse rate and risk factors for relapse during long-term PPI therapy in a prospective multicenter study.

METHODS

Patients diagnosed endoscopically as having erosive GERD according to the Los Angeles (LA) classification, with remission under PPI medication, and without mucosal damage in the esophagus, were enrolled and took rabeprazole 10 mg/day, the standard dose in Japan, for up to 104 weeks, with endoscopy at weeks 24, 52, 76, and 104; erosive GERD with LA classification grade A, B, C, or D was defined as relapse.

RESULTS

The baseline status of the 191 cases analyzed was: female (34.6%), ≥65 years old (50.8%), H. pylori-positive (40.8%), body mass index (BMI) ≥25 kg/m(2) (35.6%), and hiatus hernia (79.6%). Relapse occurred by week 104 in 21 cases (11%; 12 females, 9 males). Risk factors were hiatus hernia; severe past erosive GERD (grade C or D); H. pylori-negative; no mucosal atrophy; nonsmoking; and being female and <150 cm in height.

CONCLUSIONS

This study revealed the significant risk factors that might be monitored during long-term maintenance therapy to prevent relapse of GERD.

Authors+Show Affiliations

Department of Internal Medicine, Saga Medical School, 5-1-1 Nabeshima, Saga, 849-8501, Japan. fujimoto@med.saga-u.ac.jpNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20607308

Citation

Fujimoto, Kazuma, et al. "Risk Factors for Relapse of Erosive GERD During Long-term Maintenance Treatment With Proton Pump Inhibitor: a Prospective Multicenter Study in Japan." Journal of Gastroenterology, vol. 45, no. 12, 2010, pp. 1193-200.
Fujimoto K, Hongo M, Maintenance Study Group. Risk factors for relapse of erosive GERD during long-term maintenance treatment with proton pump inhibitor: a prospective multicenter study in Japan. J Gastroenterol. 2010;45(12):1193-200.
Fujimoto, K., & Hongo, M. (2010). Risk factors for relapse of erosive GERD during long-term maintenance treatment with proton pump inhibitor: a prospective multicenter study in Japan. Journal of Gastroenterology, 45(12), pp. 1193-200. doi:10.1007/s00535-010-0276-7.
Fujimoto K, Hongo M, Maintenance Study Group. Risk Factors for Relapse of Erosive GERD During Long-term Maintenance Treatment With Proton Pump Inhibitor: a Prospective Multicenter Study in Japan. J Gastroenterol. 2010;45(12):1193-200. PubMed PMID: 20607308.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk factors for relapse of erosive GERD during long-term maintenance treatment with proton pump inhibitor: a prospective multicenter study in Japan. AU - Fujimoto,Kazuma, AU - Hongo,Michio, AU - ,, Y1 - 2010/07/06/ PY - 2009/07/10/received PY - 2010/06/09/accepted PY - 2010/7/8/entrez PY - 2010/7/8/pubmed PY - 2011/4/7/medline SP - 1193 EP - 200 JF - Journal of gastroenterology JO - J. Gastroenterol. VL - 45 IS - 12 N2 - BACKGROUND: Despite low gastric acid secretion levels among elderly people and Helicobacter pylori-positive individuals in Japan, many patients suffer from endoscopic relapse of erosive gastroesophageal reflux disease (GERD) during standard-dose proton pump inhibitor (PPI) maintenance therapy. We aimed to investigate the relapse rate and risk factors for relapse during long-term PPI therapy in a prospective multicenter study. METHODS: Patients diagnosed endoscopically as having erosive GERD according to the Los Angeles (LA) classification, with remission under PPI medication, and without mucosal damage in the esophagus, were enrolled and took rabeprazole 10 mg/day, the standard dose in Japan, for up to 104 weeks, with endoscopy at weeks 24, 52, 76, and 104; erosive GERD with LA classification grade A, B, C, or D was defined as relapse. RESULTS: The baseline status of the 191 cases analyzed was: female (34.6%), ≥65 years old (50.8%), H. pylori-positive (40.8%), body mass index (BMI) ≥25 kg/m(2) (35.6%), and hiatus hernia (79.6%). Relapse occurred by week 104 in 21 cases (11%; 12 females, 9 males). Risk factors were hiatus hernia; severe past erosive GERD (grade C or D); H. pylori-negative; no mucosal atrophy; nonsmoking; and being female and <150 cm in height. CONCLUSIONS: This study revealed the significant risk factors that might be monitored during long-term maintenance therapy to prevent relapse of GERD. SN - 1435-5922 UR - https://www.unboundmedicine.com/medline/citation/20607308/Risk_factors_for_relapse_of_erosive_GERD_during_long_term_maintenance_treatment_with_proton_pump_inhibitor:_a_prospective_multicenter_study_in_Japan_ L2 - https://dx.doi.org/10.1007/s00535-010-0276-7 DB - PRIME DP - Unbound Medicine ER -