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Increasing body mass index influences response to treatment with dexlansoprazole or lansoprazole

A study published ahead of print the Alimentary Pharmacology & Therapeutics examines the effects of increasing body mass index on heartburn severity, frequency and response to treatment with dexlansoprazole or lansoprazole.

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Higher body mass index is a recognised risk factor for gastro-esophageal reflux disease (GERD).

Data regarding the impact of body mass index on proton pump inhibitor therapy are conflicting.

Dr Peura and colleagues assessed the impact of body mass index on baseline heartburn symptom severity and frequency and response to proton pump inhibitor therapy in patients with non-erosive gastro-esophageal reflux disease or erosive esophagitis.

In post hoc analyses of phase 3 trial data, 621 gastro-esophageal reflux disease and 2692 erosive esophagitis patients were stratified by body mass index.

The researchers noted that gastro-esophageal reflux disease patients received either dexlansoprazole MR 30 mg or placebo daily for 4 weeks.

Erosive esophagitis patients received either dexlansoprazole MR 60 mg or lansoprazole 30 mg for 8 weeks.

The team of doctors assessed the symptom frequency and severity at baseline and subsequently by daily diary.

PPI reduction in symptoms were similar across body mass index categories
Alimentary Pharmacology & Therapeutics

In both the gastro-esophageal reflux disease and erosive esophagitis cohorts, baseline heartburn severity increased with increasing body mass index.

The impact of proton pump inhibitor therapy on the reduction in heartburn symptom frequency and severity in both gastro-esophageal reflux disease and erosive esophagitis patients was similar across body mass index categories.

The researchers found that erosive esophagitis healing rates in patients treated with dexlansoprazole but not lansoprazole were higher in obese patients compared with those with a body mass index 30 kg/m2.

Differences between the proton pump inhibitor were small.

Dr Peura's team concluded, "The proton pump inhibitor evaluated in this study reduced the frequency and severity of 24-hour heartburn regardless of baseline body mass index."

"In addition, because patients with higher body mass index have more severe symptoms at baseline, they may experience greater therapeutic gain with dexlansoprazole and possibly lansoprazole treatment."

Aliment Pharmacol Ther 2013: DOI: 10.1111/apt.12270
13 March 2013

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