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The effects of increasing body mass index on heartburn severity, frequency and response to treatment with dexlansoprazole or lansoprazole.
Aliment Pharmacol Ther. 2013 Apr; 37(8):810-8.AP

Abstract

BACKGROUND

Higher body mass index (BMI) is a recognised risk factor for gastro-oesophageal reflux disease (GERD). Data regarding the impact of BMI on proton pump inhibitor (PPI) therapy are conflicting.

AIM

To assess the impact of BMI on baseline heartburn symptom severity and frequency and response to PPI therapy in patients with non-erosive GERD (NERD) or erosive oesophagitis (EO).

METHODS

In post hoc analyses of phase 3 trial data, 621 NERD and 2692 EO patients were stratified by BMI (<25, 25 to <30 and ≥30 kg/m(2)). NERD patients received either dexlansoprazole MR 30 mg or placebo daily for 4 weeks. EO patients received either dexlansoprazole MR 60 mg or lansoprazole 30 mg for 8 weeks. Symptom frequency and severity were assessed at baseline and subsequently by daily diary.

RESULTS

In both the NERD and EO cohorts, baseline heartburn severity increased with increasing BMI. The impact of PPI therapy on the reduction in heartburn symptom frequency and severity in both NERD and EO patients was similar across BMI categories. EO healing rates in patients treated with dexlansoprazole but not lansoprazole were higher in obese patients compared with those with a BMI <30 kg/m(2) . Differences between the PPIs were small.

CONCLUSIONS

The PPIs evaluated in this study reduced the frequency and severity of 24-h heartburn regardless of baseline BMI. In addition, because patients with higher BMI have more severe symptoms at baseline, they may experience greater therapeutic gain with dexlansoprazole (NERD and erosive oesophagitis) and possibly lansoprazole (erosive oesophagitis) treatment.

Authors+Show Affiliations

University of Virginia Health Sciences Center, Charlottesville, VA 22908, USA. DAP8V@hscmail.mcc.virginia.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

23451835

Citation

Peura, D A., et al. "The Effects of Increasing Body Mass Index On Heartburn Severity, Frequency and Response to Treatment With Dexlansoprazole or Lansoprazole." Alimentary Pharmacology & Therapeutics, vol. 37, no. 8, 2013, pp. 810-8.
Peura DA, Pilmer B, Hunt B, et al. The effects of increasing body mass index on heartburn severity, frequency and response to treatment with dexlansoprazole or lansoprazole. Aliment Pharmacol Ther. 2013;37(8):810-8.
Peura, D. A., Pilmer, B., Hunt, B., Mody, R., & Perez, M. C. (2013). The effects of increasing body mass index on heartburn severity, frequency and response to treatment with dexlansoprazole or lansoprazole. Alimentary Pharmacology & Therapeutics, 37(8), 810-8. https://doi.org/10.1111/apt.12270
Peura DA, et al. The Effects of Increasing Body Mass Index On Heartburn Severity, Frequency and Response to Treatment With Dexlansoprazole or Lansoprazole. Aliment Pharmacol Ther. 2013;37(8):810-8. PubMed PMID: 23451835.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effects of increasing body mass index on heartburn severity, frequency and response to treatment with dexlansoprazole or lansoprazole. AU - Peura,D A, AU - Pilmer,B, AU - Hunt,B, AU - Mody,R, AU - Perez,M C, Y1 - 2013/03/04/ PY - 2012/10/28/received PY - 2012/11/12/revised PY - 2013/01/29/revised PY - 2013/02/08/accepted PY - 2013/3/5/entrez PY - 2013/3/5/pubmed PY - 2013/9/11/medline SP - 810 EP - 8 JF - Alimentary pharmacology & therapeutics JO - Aliment. Pharmacol. Ther. VL - 37 IS - 8 N2 - BACKGROUND: Higher body mass index (BMI) is a recognised risk factor for gastro-oesophageal reflux disease (GERD). Data regarding the impact of BMI on proton pump inhibitor (PPI) therapy are conflicting. AIM: To assess the impact of BMI on baseline heartburn symptom severity and frequency and response to PPI therapy in patients with non-erosive GERD (NERD) or erosive oesophagitis (EO). METHODS: In post hoc analyses of phase 3 trial data, 621 NERD and 2692 EO patients were stratified by BMI (<25, 25 to <30 and ≥30 kg/m(2)). NERD patients received either dexlansoprazole MR 30 mg or placebo daily for 4 weeks. EO patients received either dexlansoprazole MR 60 mg or lansoprazole 30 mg for 8 weeks. Symptom frequency and severity were assessed at baseline and subsequently by daily diary. RESULTS: In both the NERD and EO cohorts, baseline heartburn severity increased with increasing BMI. The impact of PPI therapy on the reduction in heartburn symptom frequency and severity in both NERD and EO patients was similar across BMI categories. EO healing rates in patients treated with dexlansoprazole but not lansoprazole were higher in obese patients compared with those with a BMI <30 kg/m(2) . Differences between the PPIs were small. CONCLUSIONS: The PPIs evaluated in this study reduced the frequency and severity of 24-h heartburn regardless of baseline BMI. In addition, because patients with higher BMI have more severe symptoms at baseline, they may experience greater therapeutic gain with dexlansoprazole (NERD and erosive oesophagitis) and possibly lansoprazole (erosive oesophagitis) treatment. SN - 1365-2036 UR - https://www.unboundmedicine.com/medline/citation/23451835/The_effects_of_increasing_body_mass_index_on_heartburn_severity_frequency_and_response_to_treatment_with_dexlansoprazole_or_lansoprazole_ L2 - https://doi.org/10.1111/apt.12270 DB - PRIME DP - Unbound Medicine ER -