Concomitant symptoms itemized in the reflux disease questionnaire are associated with attenuated heartburn response to acid suppression

Peter J. Kahrilas, Andreas Jonsson, Hans Denison, Börje Wernersson, Nesta Hughes, Colin Howden

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

OBJECTIVES:The Reflux Disease Questionnaire (RDQ) contains six symptom items for diagnosing and gauging gastroesophageal reflux disease (GERD) severity. However, clinical trials have generally focused only on the substernal burning item and limited data exist on the effect of concomitant items on the treatment response of substernal burning.METHODS:Data from two large randomized trials of AZD0865 25-75 mg/day vs. esomeprazole 20 or 40 mg/day in patients with GERD defined by moderate to severe (4 days per week) substernal burning (non-erosive reflux disease (NERD), N1,460; reflux esophagitis (RE), N1,514) were re-analyzed. As no differences were found between drugs or doses in treatment response of substernal burning, pooled data were used to determine the impact of additional RDQ items on the response of substernal burning to acid suppression.RESULTS:At baseline, patients reported an average of four RDQ items. Substernal burning was the most responsive to therapy in the 3.3% of individuals with this as their only baseline RDQ symptom. The report of any other RDQ item was associated with a reduction in the responsiveness of substernal burning to acid suppression (e.g., RE patients with high severity dyspepsia-pain had an odds ratio of 0.20 for an improvement in substernal burning to treatment).CONCLUSIONS:Other concomitant RDQ items, particularly substernal pain or dyspepsia-pain, were associated with a reduced treatment effect of acid suppression on substernal burning. These findings support the use of a more comprehensive assessment of disease state and treatment response in GERD trials and clinical practice.

Original languageEnglish (US)
Pages (from-to)1354-1360
Number of pages7
JournalAmerican Journal of Gastroenterology
Volume107
Issue number9
DOIs
StatePublished - Sep 1 2012
Externally publishedYes

Fingerprint

Heartburn
Acids
Gastroesophageal Reflux
Peptic Esophagitis
Dyspepsia
Pain
Therapeutics
Esomeprazole
Clinical Trials
Surveys and Questionnaires
Odds Ratio

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cite this

Concomitant symptoms itemized in the reflux disease questionnaire are associated with attenuated heartburn response to acid suppression. / Kahrilas, Peter J.; Jonsson, Andreas; Denison, Hans; Wernersson, Börje; Hughes, Nesta; Howden, Colin.

In: American Journal of Gastroenterology, Vol. 107, No. 9, 01.09.2012, p. 1354-1360.

Research output: Contribution to journalArticle

Kahrilas, Peter J. ; Jonsson, Andreas ; Denison, Hans ; Wernersson, Börje ; Hughes, Nesta ; Howden, Colin. / Concomitant symptoms itemized in the reflux disease questionnaire are associated with attenuated heartburn response to acid suppression. In: American Journal of Gastroenterology. 2012 ; Vol. 107, No. 9. pp. 1354-1360.
@article{8302514569444c5eb421e12ca09d64a3,
title = "Concomitant symptoms itemized in the reflux disease questionnaire are associated with attenuated heartburn response to acid suppression",
abstract = "OBJECTIVES:The Reflux Disease Questionnaire (RDQ) contains six symptom items for diagnosing and gauging gastroesophageal reflux disease (GERD) severity. However, clinical trials have generally focused only on the substernal burning item and limited data exist on the effect of concomitant items on the treatment response of substernal burning.METHODS:Data from two large randomized trials of AZD0865 25-75 mg/day vs. esomeprazole 20 or 40 mg/day in patients with GERD defined by moderate to severe (4 days per week) substernal burning (non-erosive reflux disease (NERD), N1,460; reflux esophagitis (RE), N1,514) were re-analyzed. As no differences were found between drugs or doses in treatment response of substernal burning, pooled data were used to determine the impact of additional RDQ items on the response of substernal burning to acid suppression.RESULTS:At baseline, patients reported an average of four RDQ items. Substernal burning was the most responsive to therapy in the 3.3{\%} of individuals with this as their only baseline RDQ symptom. The report of any other RDQ item was associated with a reduction in the responsiveness of substernal burning to acid suppression (e.g., RE patients with high severity dyspepsia-pain had an odds ratio of 0.20 for an improvement in substernal burning to treatment).CONCLUSIONS:Other concomitant RDQ items, particularly substernal pain or dyspepsia-pain, were associated with a reduced treatment effect of acid suppression on substernal burning. These findings support the use of a more comprehensive assessment of disease state and treatment response in GERD trials and clinical practice.",
author = "Kahrilas, {Peter J.} and Andreas Jonsson and Hans Denison and B{\"o}rje Wernersson and Nesta Hughes and Colin Howden",
year = "2012",
month = "9",
day = "1",
doi = "10.1038/ajg.2012.197",
language = "English (US)",
volume = "107",
pages = "1354--1360",
journal = "American Journal of Gastroenterology",
issn = "0002-9270",
publisher = "Nature Publishing Group",
number = "9",

}

TY - JOUR

T1 - Concomitant symptoms itemized in the reflux disease questionnaire are associated with attenuated heartburn response to acid suppression

AU - Kahrilas, Peter J.

AU - Jonsson, Andreas

AU - Denison, Hans

AU - Wernersson, Börje

AU - Hughes, Nesta

AU - Howden, Colin

PY - 2012/9/1

Y1 - 2012/9/1

N2 - OBJECTIVES:The Reflux Disease Questionnaire (RDQ) contains six symptom items for diagnosing and gauging gastroesophageal reflux disease (GERD) severity. However, clinical trials have generally focused only on the substernal burning item and limited data exist on the effect of concomitant items on the treatment response of substernal burning.METHODS:Data from two large randomized trials of AZD0865 25-75 mg/day vs. esomeprazole 20 or 40 mg/day in patients with GERD defined by moderate to severe (4 days per week) substernal burning (non-erosive reflux disease (NERD), N1,460; reflux esophagitis (RE), N1,514) were re-analyzed. As no differences were found between drugs or doses in treatment response of substernal burning, pooled data were used to determine the impact of additional RDQ items on the response of substernal burning to acid suppression.RESULTS:At baseline, patients reported an average of four RDQ items. Substernal burning was the most responsive to therapy in the 3.3% of individuals with this as their only baseline RDQ symptom. The report of any other RDQ item was associated with a reduction in the responsiveness of substernal burning to acid suppression (e.g., RE patients with high severity dyspepsia-pain had an odds ratio of 0.20 for an improvement in substernal burning to treatment).CONCLUSIONS:Other concomitant RDQ items, particularly substernal pain or dyspepsia-pain, were associated with a reduced treatment effect of acid suppression on substernal burning. These findings support the use of a more comprehensive assessment of disease state and treatment response in GERD trials and clinical practice.

AB - OBJECTIVES:The Reflux Disease Questionnaire (RDQ) contains six symptom items for diagnosing and gauging gastroesophageal reflux disease (GERD) severity. However, clinical trials have generally focused only on the substernal burning item and limited data exist on the effect of concomitant items on the treatment response of substernal burning.METHODS:Data from two large randomized trials of AZD0865 25-75 mg/day vs. esomeprazole 20 or 40 mg/day in patients with GERD defined by moderate to severe (4 days per week) substernal burning (non-erosive reflux disease (NERD), N1,460; reflux esophagitis (RE), N1,514) were re-analyzed. As no differences were found between drugs or doses in treatment response of substernal burning, pooled data were used to determine the impact of additional RDQ items on the response of substernal burning to acid suppression.RESULTS:At baseline, patients reported an average of four RDQ items. Substernal burning was the most responsive to therapy in the 3.3% of individuals with this as their only baseline RDQ symptom. The report of any other RDQ item was associated with a reduction in the responsiveness of substernal burning to acid suppression (e.g., RE patients with high severity dyspepsia-pain had an odds ratio of 0.20 for an improvement in substernal burning to treatment).CONCLUSIONS:Other concomitant RDQ items, particularly substernal pain or dyspepsia-pain, were associated with a reduced treatment effect of acid suppression on substernal burning. These findings support the use of a more comprehensive assessment of disease state and treatment response in GERD trials and clinical practice.

UR - http://www.scopus.com/inward/record.url?scp=84866106727&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84866106727&partnerID=8YFLogxK

U2 - 10.1038/ajg.2012.197

DO - 10.1038/ajg.2012.197

M3 - Article

VL - 107

SP - 1354

EP - 1360

JO - American Journal of Gastroenterology

JF - American Journal of Gastroenterology

SN - 0002-9270

IS - 9

ER -