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Evolution of gastro-oesophageal reflux disease over 5 years under routine medical care--the ProGERD study.
Aliment Pharmacol Ther 2012; 35(1):154-64AP

Abstract

BACKGROUND

The evolution of gastro-oesophageal reflux disease (GERD) under current management options remains uncertain.

AIM

To examine whether, depending on the initial presentation, non-erosive (NERD) and erosive reflux disease (ERD) without Barrett's oesophagus will progress to more severe disease under current routine care following the resolution of the initial condition.

METHODS

Patients with the primary symptom of heartburn were included at baseline, and stratified into non-erosive (NERD) and erosive reflux disease (ERD), LA grades A-D (Los Angeles classification). After a 2- to 8-week course with esomeprazole therapy to achieve endoscopic healing in ERD and symptom relief in NERD, patients were treated routinely at the discretion of their physician. We report oesophagitis status and the presence of endoscopic and confirmed Barrett's oesophagus after 5 years.

RESULTS

A total of 6215 patients were enrolled in the study of whom 2721 patients completed the 5-year follow-up. Progression, regression and stability of GERD severity were followed from baseline to 5 years. Only a few patients with NERD and mild/moderate ERD progressed to severe forms of ERD and even Barrett's oesophagus. Most patients remained stable or showed improvement in their oesophagitis; 5.9% of the NERD patients, 12.1% of LA grade A/B patients and 19.7% of LA grade C/D patients in whom no Barrett's oesophagus was recorded at baseline progressed to endoscopic or confirmed Barrett's oesophagus at 5 years.

CONCLUSION

Most GERD patients remain stable or improve over a 5-year observation period under current routine clinical care.

Authors+Show Affiliations

Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University, Magdeburg, Germany. peter.malfertheiner@med.ovgu.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

22070159

Citation

Malfertheiner, P, et al. "Evolution of Gastro-oesophageal Reflux Disease Over 5 Years Under Routine Medical Care--the ProGERD Study." Alimentary Pharmacology & Therapeutics, vol. 35, no. 1, 2012, pp. 154-64.
Malfertheiner P, Nocon M, Vieth M, et al. Evolution of gastro-oesophageal reflux disease over 5 years under routine medical care--the ProGERD study. Aliment Pharmacol Ther. 2012;35(1):154-64.
Malfertheiner, P., Nocon, M., Vieth, M., Stolte, M., Jaspersen, D., Koelz, H. R., ... Willich, S. N. (2012). Evolution of gastro-oesophageal reflux disease over 5 years under routine medical care--the ProGERD study. Alimentary Pharmacology & Therapeutics, 35(1), pp. 154-64. doi:10.1111/j.1365-2036.2011.04901.x.
Malfertheiner P, et al. Evolution of Gastro-oesophageal Reflux Disease Over 5 Years Under Routine Medical Care--the ProGERD Study. Aliment Pharmacol Ther. 2012;35(1):154-64. PubMed PMID: 22070159.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evolution of gastro-oesophageal reflux disease over 5 years under routine medical care--the ProGERD study. AU - Malfertheiner,P, AU - Nocon,M, AU - Vieth,M, AU - Stolte,M, AU - Jaspersen,D, AU - Koelz,H R, AU - Labenz,J, AU - Leodolter,A, AU - Lind,T, AU - Richter,K, AU - Willich,S N, Y1 - 2011/11/09/ PY - 2011/11/11/entrez PY - 2011/11/11/pubmed PY - 2012/4/13/medline SP - 154 EP - 64 JF - Alimentary pharmacology & therapeutics JO - Aliment. Pharmacol. Ther. VL - 35 IS - 1 N2 - BACKGROUND: The evolution of gastro-oesophageal reflux disease (GERD) under current management options remains uncertain. AIM: To examine whether, depending on the initial presentation, non-erosive (NERD) and erosive reflux disease (ERD) without Barrett's oesophagus will progress to more severe disease under current routine care following the resolution of the initial condition. METHODS: Patients with the primary symptom of heartburn were included at baseline, and stratified into non-erosive (NERD) and erosive reflux disease (ERD), LA grades A-D (Los Angeles classification). After a 2- to 8-week course with esomeprazole therapy to achieve endoscopic healing in ERD and symptom relief in NERD, patients were treated routinely at the discretion of their physician. We report oesophagitis status and the presence of endoscopic and confirmed Barrett's oesophagus after 5 years. RESULTS: A total of 6215 patients were enrolled in the study of whom 2721 patients completed the 5-year follow-up. Progression, regression and stability of GERD severity were followed from baseline to 5 years. Only a few patients with NERD and mild/moderate ERD progressed to severe forms of ERD and even Barrett's oesophagus. Most patients remained stable or showed improvement in their oesophagitis; 5.9% of the NERD patients, 12.1% of LA grade A/B patients and 19.7% of LA grade C/D patients in whom no Barrett's oesophagus was recorded at baseline progressed to endoscopic or confirmed Barrett's oesophagus at 5 years. CONCLUSION: Most GERD patients remain stable or improve over a 5-year observation period under current routine clinical care. SN - 1365-2036 UR - https://www.unboundmedicine.com/medline/citation/22070159/Evolution_of_gastro_oesophageal_reflux_disease_over_5_years_under_routine_medical_care__the_ProGERD_study_ L2 - https://doi.org/10.1111/j.1365-2036.2011.04901.x DB - PRIME DP - Unbound Medicine ER -