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On-demand Versus Continuous Maintenance Treatment With a Proton Pump Inhibitor for Mild Gastroesophageal Reflux Disease: A Prospective Randomized Multicenter Study
- Title
- On-demand Versus Continuous Maintenance Treatment With a Proton Pump Inhibitor for Mild Gastroesophageal Reflux Disease: A Prospective Randomized Multicenter Study
- Authors
- Jung; Da Hyun; Youn; Young Hoon; Hye-Kyung; Kim; Seung Young; Huh; Cheal Wung; Shin; Cheol Min; Oh; Jung-Hwan; Kyu Chan; Park; Moo In; Choi; Suck Chei; Ki Bae; Seon-Young; Kwon; Joong Goo; Cho; Yu Kyung; Jung Ho; Jeong Eun; Gong; Eun Jeong; Jae Hak; Hong; Su Jin; Hyun Jin; Jee; Sam Ryong; Lee; Ju Yup; Kee Wook; Hee Man; Kwang Jae
- Ewha Authors
- 정혜경
- SCOPUS Author ID
- 정혜경
- Issue Date
- 2023
- Journal Title
- Journal of Neurogastroenterology and Motility
- ISSN
- 2093-0879
- Citation
- Journal of Neurogastroenterology and Motility vol. 29, no. 4, pp. 460 - 469
- Keywords
- Gastroesophageal reflux; Maintenance; Proton pump inhibitors
- Publisher
- Korean Society of Neurogastroenterology and Motility
- Indexed
- SCIE; SCOPUS; KCI
- Document Type
- Article
- Abstract
- Background/Aims It remains unclear which maintenance treatment modality is most appropriate for mild gastroesophageal reflux disease (GERD). We aimed to compare on-demand treatment with continuous treatment using a proton pump inhibitor (PPI) in the maintenance treatment for patients with non-erosive GERD or mild erosive esophagitis. Methods Patients whose GERD symptoms improved after 4 weeks of standard dose PPI treatment were prospectively enrolled at 25 hospitals. Subsequently, the enrolled patients were randomly assigned to either an on-demand or a continuous maintenance treatment group, and followed in an 8-week interval for up to 24 weeks. Results A total of 304 patients were randomized to maintenance treatment (continuous, n = 151 vs on-demand, n = 153). The primary outcome, the overall proportion of unwillingness to continue the assigned maintenance treatment modality, failed to confirm the non-inferiority of on-demand treatment (45.9%) compared to continuous treatment (36.1%). Compared with the on-demand group, the GERD symptom and health-related quality of life scores significantly more improved and the overall satisfaction score was significantly higher in the continuous treatment group, particularly at week 8 and week 16 of maintenance treatment. Work impairment scores were not different in the 2 groups, but the prescription cost was less in the on-demand group. Serum gastrin levels significantly elevated in the continuous treatment group, but not in the on-demand group. Conclusions Continuous treatment seems to be more appropriate for the initial maintenance treatment of non-erosive GERD or mild erosive esophagitis than on-demand treatment. Stepping down to on-demand treatment needs to be considered after a sufficient period of continuous treatment. © 2023 The Korean Society of Neurogastroenterology and Motility.
- DOI
- 10.5056/jnm23130
- Appears in Collections:
- 의과대학 > 의학과 > Journal papers
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