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Distinguishing the impact of dexlansoprazole on heartburn vs regurgitation in GERD

The latest issue of Alimentary Pharmacology & Therapeutics examines the impact of dexlansoprazole on heartburn vs regurgitation in patients with gastro-esophageal reflux disease.

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Gastro-esophageal reflux disease (GERD) is characterised by symptomatic heartburn and regurgitation.

Treatment with proton pump inhibitors (PPI) effectively decreases heartburn symptoms, but their effects on symptomatic regurgitation are less clear.

Dr Peura and colleagues from Virginia, USA determined the impact of PPI therapy on heartburn and regurgitation severity in patients with either non-erosive GERD (NERD) or erosive esophagitis.

Endoscopically-confirmed NERD patients received dexlansoprazole 30 or 60 mg or placebo in a randomized, blinded, 4-week study.

NERD patients receiving dexlansoprazole experienced greater improvements in symptom severity
Alimentary Pharmacology & Therapeutics

Endoscopically-confirmed erosive esophagitis patients received dexlansoprazole 60 mg or lansoprazole 30 mg in two 8-week, randomized, blinded healing studies.

The Patient Assessment of Upper Gastrointestinal Symptom Severity questionnaire, which includes a heartburn/regurgitation subscale, was administered to assess symptom severity at baseline, and at weeks 2 and 4 of the NERD study, and at weeks 4 and 8 during the erosive esophagitis trials.

The researchers defined separate subscales for heartburn and regurgitation for this post-hoc analysis.

Among patients with both symptoms at baseline, improvements in individual heartburn and regurgitation subscales along with the original combined heartburn/regurgitation subscale were determined.

The research team found that in the NERD and erosive esophagitis studies, 661 and 1909 patients, respectively, had both heartburn and regurgitation at baseline.

The team noted that NERD patients receiving dexlansoprazole 30 and 60 mg experienced significantly greater improvements in symptom severity for both heartburn and regurgitation compared with placebo.

The researchers found that erosive esophagitis patients receiving dexlansoprazole 60 mg had significantly greater improvements in heartburn/regurgitation and heartburn-only subscales at week 4 compared with those receiving lansoprazole.

Dr Peura's team concludes, "Dexlansoprazole appears to be effective in improving both heartburn and regurgitation, and this improvement is maintained for the duration of treatment."

Aliment Pharmacol Ther 2013: 38(10): 13031311
11 November 2013

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