The efficacy of proton pump inhibitors in functional dyspepsia is modest, and the prognostic factors are almost unknown.
In this study, researchers from Australia and Scandinavia assessed 826 patients with functional dyspepsia from two placebo-controlled trials, who were treated with omeprazole, 10 or 20 mg daily, for 4 weeks.
Patients used self-administered questionnaires to assess their symptoms and health-related quality of life before entry to the study. Any epigastric pain or discomfort was recorded on diary cards.
The team defined treatment success as the complete absence of epigastric pain or discomfort on each of the last 3 days of week 4.
|Fewer days with symptoms during the first week resulted in higher response rates at 4 weeks.|
|Alimentary Pharmacology and Therapeutics|
They identified prognostic factors using multiple logistic regression analysis.
The researchers found that the most discriminating predictor of treatment success was the number of days with epigastric pain or discomfort during the first week of treatment.
They established that fewer days with symptoms during the first week resulted in higher response rates at 4 weeks.
They also found that age greater than 40 years, bothersome heartburn, low scores for bloating, epigastric pain and diarrhea, history of symptoms for less than 3 months, and low impairment of vitality at baseline were all positive predictors of outcome.
Dr Bolling-Sternevald's team concluded, "Early response to treatment with a proton pump inhibitor, during the first week, seems to predict the outcome after 4 weeks in patients with functional dyspepsia".