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News

Predictors of rapid healing in reflux esophagitis

This month's issue of the Alimentary Pharmacology & Therapeutics identifies predictors of either rapid healing or refractory reflux esophagitis during treatment with potent acid suppression.

News image

Little is known regarding patient characteristics that influence the speed of reflux esophagitis healing.

Dr Kahrilas and colleagues from Illinois, USA investigated patient characteristics that may influence reflux esophagitis healing rates.

The team conducted a post hoc analysis of clinical trial data for potent acid suppression treatment of reflux esophagitis.

Group 1 underwent endoscopy at baseline, week 2 and 4, and Group 2 at baseline, week 4 and 8.

Group 1 patients were sub-grouped as ‘rapid’ (healed at 2 weeks) or unhealed at 2 weeks.

Reflux esophagitis had healed in 68%
Alimentary Pharmacology & Therapeutics

Group 2 patients were sub-grouped as ‘slow’ (healed at 8 weeks, not at 4 weeks) or ‘refractory’ (not healed at 8 weeks).

Logistic regression analysis was performed only for comparisons within Group 1.

At 2, 4 and 8 weeks, reflux esophagitis had healed in 68%, 65% and 61% of patients unhealed at previous endoscopy, respectively.

The team found that low-grade reflux esophagitis was the only independent predictor of rapid healing in Group 1 after logistic regression analysis.

The researchers found that significantly more rapid healers had low grade reflux esophagitis at baseline than patients with refractory reflux esophagitis, and significantly more refractory patients had frequent regurgitation at baseline than slow healers.

Dr Kahrilas' team concludes, "Low-grade reflux esophagitis determines the most rapid benefit from acid suppression."

"Roughly two-thirds of patients healed with each time increment of potent acid suppression therapy."

"This suggests that some unhealed patients may still heal with continued therapy and that truly refractory reflux esophagitis is rare."

Aliment Pharmacol Ther 2014: 40(6): 648–656
05 September 2014

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