Clinical symptoms of FSSG in gastroesophageal reflux disease are critical for PPI treatment: Japanese multi-centers with 185 patients.

The main aim of this study was to determine whether questionnaire evaluations of clinical symptoms in gastroesophageal reflux disease were useful to assess proton pump inhibitor therapy. A total of 185 Japanese patients (men, 88; women, 97; age: 55.7 ± 16.1 years) with gastroesophageal reflux disease were enrolled. The patients were divided based on the frequency scale for symptoms of gastroesophageal reflux disease: severe symptoms with scores ≥8 and mild symptoms with scores ≤7. Quality of life was evaluated with the Medical Outcomes Study 8-Item Short-Form Health Survey. All patients were treated with a proton pump inhibitor, rabeprazole (10 mg/day), for 8 weeks. Patients were classified into four groups: reflux esophagitis with severe symptoms (n = 92, 49.7%); reflux esophagitis with mild symptoms (n = 17, 9.2%); non-erosive reflux disease with severe symptoms (n = 66, 35.7%); and non-erosive reflux disease with mild symptoms (n = 10, 5.4%). The dysmotility score was high in non-erosive reflux disease with severe symptoms compared with reflux esophagitis with severe symptoms (9.1 ± 0.5 vs 6.8 ± 0.5, P < 0.05). The symptom score and quality of life in the severe symptoms groups for both reflux esophagitis and non-erosive reflux disease were significantly improved by rabeprazole treatment. Only the reflux score was improved by rabeprazole in the reflux esophagitis with mild symptoms group; no therapeutic effect was observed for the non-erosive reflux disease with mild symptoms group. Low scores on the frequency scale for the symptoms of gastroesophageal reflux disease indicate poor responsiveness to proton pump inhibitor treatment, and high scores indicate good responsiveness.

Komatsu-Tanaka M ，Iwakiri R ，Fujimoto K ，Fujiwara Y ，Inamori M ，Tanaka J ，Shimatani T ，Akiyama J ，Ando T ，Manabe N ，Kinjo F ，Deguchi R ，Kusano M ... -  《-》

Irsogladine maleate and rabeprazole in non-erosive reflux disease: A double-blind, placebo-controlled study.

Suzuki T ，Matsushima M ，Masui A ，Tsuda S ，Imai J ，Nakamura J ，Tsukune Y ，Uchida T ，Yuhara H ，Igarashi M ，Koike J ，Mine T ... -  《-》

Symptoms and quality of life in underweight gastroesophageal reflux disease patients and therapeutic responses to proton pump inhibitors.

A correlation to obesity has been reported in patients with gastroesophageal reflux disease (GERD). However, insufficient data have been obtained regarding underweight GERD patients. Post hoc analysis of a multicenter prospective cohort study was conducted to evaluate subjective symptoms and health-related quality of life (HRQOL) in underweight GERD patients (body mass index [BMI] < 18.5) and to evaluate therapeutic response to proton pump inhibitors. A total of 2646 patients who underwent endoscopy were classified by BMI and analyzed. Rabeprazole was administered for 8 weeks. Subjective symptoms and HRQOL were assessed using questionnaires (F-Scale and SF-8™). Baseline endoscopy revealed 29.2% of patients had non-erosive reflux disease (NERD). Underweight status was identified in 5.8% of GERD patients, and mean baseline symptoms score and SF-8 physical component summary (PCS) score were 18.6 and 42.4, respectively, reflecting greater impairment compared with the values of 15.4 and 45.6 in normal-weight patients (BMI ≥ 22 but < 25). Treatment with rabeprazole resulted in a decrease from 18.6 at baseline to 6.7 at week 8 in underweight reflux esophagitis subjects, and from 15.0 to 6.3 in underweight NERD patients. PCS score improved in underweight patients. These changes were about the same as in normal-weight or obese patients. Japanese GERD patients are often obese, as reported previously, but some GERD patients are underweight. Baseline symptoms and QOL in underweight GERD patients tended to be more severe than in normal-weight patients, but therapeutic response with proton pump inhibitors was about the same as in normal-weight or obese patients.

Hongo M ，Miwa H ，Kusano M ，J-FAST group ... -  《-》

[Long-term impact on quality of life in patients with gastroesophageal reflux disease after 52-week rabeprazole treatment].

Yang XL ，Liu XH ，Ke MY ，Song ZQ ，Yuan YZ ，Luo JY ，Hou XH ... -  《-》

Response to gastroesophageal reflux disease therapy: assessment at 4 weeks predicts response/non-response at 8 weeks.

Many questionnaires that assess subjective symptoms or health-related quality of life (HRQOL) have been developed to confirm the efficacy of treatment in patients with gastroesophageal reflux disease (GERD). However, few reports have correlated early improvements in scale scores with predictions of subsequent therapeutic responses. Our aim was to investigate the appropriate timing for evaluating therapeutic response and subsequent changes in symptoms and HRQOL. This was a post hoc analysis of a multicenter prospective cohort study. A total of 5,279 GERD patients with Frequency Scale for the Symptoms of GERD (FSSG) scores ≥ 8 points at baseline were analyzed. Correlations between HRQOL and FSSG were investigated and logistic regression analysis was performed. The FSSG scores and HRQOL improvements in responders were significantly greater than in non-responders. Positive correlation between FSSG and HRQOL was observed. Based on the analysis, severity of esophagitis at baseline, complications of hypertension, higher HRQOL mental score at baseline, and higher FSSG score at baseline were predictors of responders. Gastrectomy, complication of insomnia, and prior medication with proton pump inhibitors were predictors of non-responders. Evaluating patients' symptoms during the fourth week of rabeprazole therapy allows predictions of subsequent changes in subjective symptoms and HRQOL.

Kusano M ，Hongo M ，Miwa H 《-》