Featured Research

from universities, journals, and other organizations

Modern treatments for GERD effective at achieving long-term remission for most patients, study finds

Date:
May 17, 2011
Source:
JAMA and Archives Journals
Summary:
In an evaluation of contemporary antireflux therapies for chronic gastroesophageal reflux disease (GERD), most patients who received treatment with either the proton pump inhibitor esomeprazole or laparoscopic antireflux surgery achieved and remained in disease remission for 5 years, according to a new study.

In an evaluation of contemporary antireflux therapies for chronic gastroesophageal reflux disease (GERD), most patients who received treatment with either the proton pump inhibitor esomeprazole or laparoscopic antireflux surgery achieved and remained in disease remission for 5 years, according to a study in the May 18 issue of JAMA.

"GERD is a highly prevalent disorder caused by the reflux of gastric contents into the esophagus. It is a chronic, relapsing disease that negatively affects patients' health-related quality of life and reduces work productivity," according to background information in the article. Two treatment options are long-term medication (such as with a proton pump inhibitor [PPI]) or surgery (laparoscopic antireflux surgery [LARS]). Some patients are reluctant to take long-term medication and may prefer to have antireflux surgery. Few studies have compared pharmaceutical treatment for GERD with LARS, particularly over a longer term.

Jean-Paul Galmiche, M.D., F.R.C.P., of Nantes University, Nantes, France, and colleagues compared maintenance therapy for chronic GERD provided by the PPI esomeprazole (dose-adjusted when required) with standardized LARS in patients who responded well to acid-suppressive therapy. The 5-year randomized trial was conducted in academic hospitals in 11 European countries between October 2001 and April 2009 among 554 patients. A total of 372 patients (192 assigned to receive esomeprazole [20 to 40 mg/d, allowing for dose adjustments]; 180 assigned to undergo LARS) completed 5-year follow-up. The primary outcome for the study was time to treatment failure (for LARS, defined as need for acid suppressive therapy; for esomeprazole, inadequate symptom control after dose adjustment), expressed as estimated remission rates.

The researchers found that at 5 years, an estimated 85 percent of patients in the LARS group and an estimated 92 percent in the esomeprazole group remained in remission. The esomeprazole group showed similar levels of symptoms of heartburn and acid regurgitation from the beginning of the study up to 5 years, whereas these symptoms decreased in the LARS group after randomization.

"At 5 years, acid regurgitation was significantly worse in the esomeprazole group than in the LARS group (13 percent vs. 2 percent, respectively), although there was no significant difference between the groups in the severity of heartburn (16 percent vs. 8 percent), epigastric [an area of the abdomen] pain (18 percent vs. 18 percent), or diarrhea (15 percent vs. 16 percent). At 5 years, dysphagia [difficulty swallowing] remained significantly more common in the LARS group than in the esomeprazole group (11 percent vs. 5 percent, respectively), as did bloating (40 percent vs. 28 percent, respectively) and flatulence (57 percent vs. 40 percent, respectively)," the authors write.

Serious adverse events were reported by 28.6 percent of patients who underwent LARS and by 24.1 percent of patients in the esomeprazole group over 5 years.

"This large, multicenter randomized trial demonstrated that with modern forms of antireflux therapy, either by drug-induced acid suppression or after LARS, most patients remain in remission for at least 5 years," the authors conclude.


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Journal Reference:

  1. J.-P. Galmiche, J. Hatlebakk, S. Attwood, C. Ell, R. Fiocca, S. Eklund, G. Langstrom, T. Lind, L. Lundell. Laparoscopic Antireflux Surgery vs Esomeprazole Treatment for Chronic GERD: The LOTUS Randomized Clinical Trial. JAMA: The Journal of the American Medical Association, 2011; 305 (19): 1969 DOI: 10.1001/jama.2011.626

Cite This Page:

JAMA and Archives Journals. "Modern treatments for GERD effective at achieving long-term remission for most patients, study finds." ScienceDaily. ScienceDaily, 17 May 2011. <www.sciencedaily.com/releases/2011/05/110517162024.htm>.
JAMA and Archives Journals. (2011, May 17). Modern treatments for GERD effective at achieving long-term remission for most patients, study finds. ScienceDaily. Retrieved April 20, 2014 from www.sciencedaily.com/releases/2011/05/110517162024.htm
JAMA and Archives Journals. "Modern treatments for GERD effective at achieving long-term remission for most patients, study finds." ScienceDaily. www.sciencedaily.com/releases/2011/05/110517162024.htm (accessed April 20, 2014).

Share This



More Health & Medicine News

Sunday, April 20, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Nine-Month-Old Baby Can't Open His Mouth

Nine-Month-Old Baby Can't Open His Mouth

Newsy (Apr. 19, 2014) Nine-month-old Wyatt Scott was born with a rare disorder called congenital trismus, which prevents him from opening his mouth. Video provided by Newsy
Powered by NewsLook.com
'Holy Grail' Of Weight Loss? New Find Could Be It

'Holy Grail' Of Weight Loss? New Find Could Be It

Newsy (Apr. 18, 2014) In a potential breakthrough for future obesity treatments, scientists have used MRI scans to pinpoint brown fat in a living adult for the first time. Video provided by Newsy
Powered by NewsLook.com
Little Progress Made In Fighting Food Poisoning, CDC Says

Little Progress Made In Fighting Food Poisoning, CDC Says

Newsy (Apr. 18, 2014) A new report shows rates of two foodborne infections increased in the U.S. in recent years, while salmonella actually dropped 9 percent. Video provided by Newsy
Powered by NewsLook.com
Scientists Create Stem Cells From Adult Skin Cells

Scientists Create Stem Cells From Adult Skin Cells

Newsy (Apr. 17, 2014) The breakthrough could mean a cure for some serious diseases and even the possibility of human cloning, but it's all still a way off. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins