Abstract:
BACKGROUND:While empiric acid-suppressive therapy for uninvestigated dyspepsia patients with symptoms of epigastric pain or burning is standard practice, it is unknown whether an early response to therapy predicts outcome. AIM:To evaluate whether a 1-w acid suppression trial is effective for predicting 8-w response in such patients. METHODS:Helicobacter pylori-negative patients (aged 18-50 years) in primary care with uninvestigated epigastric pain or burning were randomized to esomeprazole 40 mg q.d.s. or b.d. for 1w, followed by esomeprazole 40 mg q.d.s. or placebo for 7w. Each day, patients rated the severity of their symptoms. RESULTS:Based on the last 3d, 1-w response rates were 39% (231 of 588) and 43% (258 of 596) with esomeprazole 40 mg q.d.s. and b.d., respectively. Based on the last 7d, response rates at 4w were 38% (283 of 738) and 25% (93 of 380) for esomeprazole and placebo, respectively, and 47% (339 of 716) and 34% (124 of 368), respectively, at 8w (both P < 0.001 vs. placebo). The sensitivity and specificity of esomeprazole treatment were 58% and 70%, respectively, at 8w. CONCLUSION:A 1-w acid suppression trial is of limited clinical value for predicting 8-w response in patients with symptoms of epigastric pain or burning. Esomeprazole provides greater symptom control than placebo at 4w and 8w.
journal_name
Aliment Pharmacol Therjournal_title
Alimentary pharmacology & therapeuticsauthors
van Zanten SV,Flook N,Talley NJ,Vakil N,Lauritsen K,Bolling-Sternevald E,Persson T,Björck E,Svedberg LE,STARS II Study Group.doi
10.1111/j.1365-2036.2007.03409.xsubject
Has Abstractpub_date
2007-09-01 00:00:00pages
665-72issue
5eissn
0269-2813issn
1365-2036pii
APT3409journal_volume
26pub_type
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