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The Reflux Disease Questionnaire contains 6 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'. Dr Peter Kahrilas and colleagues from the United Kingdom evaluated data from 2 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 'substernal burning'.  | | Patients reported an average of 4 Reflux Disease Questionnaire items | | American Journal of Gastroenterology |
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 Reflux Disease Questionnaire items on the response of 'substernal burning' to acid suppression. At baseline, patients reported an average of 4 Reflux Disease Questionnaire items. The research team observed that 'Substernal burning' was the most responsive to therapy in the 3% of individuals with this as their only baseline Reflux Disease Questionnaire symptom. The team noted that the report of any other Reflux Disease Questionnaire item was associated with a reduction in the responsiveness of 'substernal burning' to acid suppression. Dr Kahrilas' team concludes, "Other concomitant Reflux Disease Questionnaire 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."
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