Early identification of true responders to acid suppression in functional dyspepsia patients with symptoms of epigastric pain or burning may enable clinicians to optimally tailor treatment.
Dr Nicholas Talley and colleagues from Sweden evaluated undertook a 1-week acid suppression trial to identify true responders in this population.
|Trial week sensitivity was 46% for esomeprazole|
|Alimentary Pharmacology & Therapeutics|
The team assessed patients between 18 and 70 years.
The patients were randomized to either esomeprazole 40 mg q.d.s., b.d. or placebo for 1 week, and then esomeprazole 40 mg q.d.s. or placebo for 7 weeks.
Epigastric pain and/or burning were recorded on a 4-point scale, with 0 being none, and 3 scored as severe.
Trial-week response was defined as symptom score sum equal to 1 on the last 3 days of therapy.
Response at 8 weeks was a symptom score sum equal to 1 over the preceding 7 days.
The researchers found that 1-week response rates were 33%, 29%, and 23% with esomeprazole q.d.s., esomeprazole b.d. and placebo, respectively.
At 8 weeks, trial week sensitivity and specificity were 46% and 80%, respectively, for esomeprazole (40 or 80 mg), and 33% and 87%, respectively, for placebo.
The team observed that the positive and negative predictive values for esomeprazole were 60% and 69%.
Dr Talley's team concluded, "Response to a 1-week acid suppression trial is of limited use for predicting symptom response at 8 weeks in patients with unexplained epigastric pain or burning."