Healthcare costs of GERD and acid-related conditions in pediatric patients,with comparison between histamine-2 receptor antagonists and proton pump inhibitors

Abstract

Background:

Gastroesophageal reflux disease and acid-related conditions (GERD/ARC) are common in pediatric practice but their costs have not been well characterized.     

Effect of adjustable gastric banding on changes in gastroesophageal reflux disease (GERD) and quality of life

Abstract

Objective:

Bariatric surgery is an effective treatment for the reduction of weight in obese patients (BMI?≥?40?kg/m² or 30?kg/m² with ≥1 comorbidities), who are refractory to behavioral and medical therapies. This study examined the effect of the adjustable gastric band (AGB) system on changes in gastroesophageal reflux disease (GERD) and patient-reported outcomes, including measures of quality of life.     

Oesophageal acid exposure and altered neurocardiac function in patients with GERD and idiopathic cardiac dysrhythmias

Summary

Background

Oesophageal sensory stimuli alter neurocardiac function through autonomic reflexes.

Aim

To evaluate in patients with idiopathic supraventricular cardiac dysrhythmias and gastro‐oesophageal reflux disease (GERD) whether GE reflux alters neurocardiac function and the effect of acid suppression on cardiac symptoms.

Methods

Thirty‐two patients (13 females and 19 males; age: 20–69 years) with dysrhythmias plus GERD, and nine patients (five females and four males; age: 43–58 years) with GERD only, underwent simultaneous 24‐h pH‐metry and ECG monitoring. Power spectrum analysis of heart rate variability (PSHRV) was obtained with both its low frequency (LF, sympathetic modulation) and high frequency (HF, vagal modulation) components. Hourly mean oesophageal pH and LF/HF ratio were correlated. A 3 months full‐dosage PPI therapy (esomeprazole 40 mg/day) was prescribed.

Results

In 18 (56%) of the 32 patients with dysrhythmia and in none with GERD only, a significant (P < 0.05) correlation between oesophageal pH and LF/HF ratio (oesophagus–heart correlation) was observed. A significant reduction of cardiac symptoms after PPI therapy was observed only in these patients (13/16 vs. 4/11, P < 0.01).

Conclusions

This study has identified a subgroup of dysrhythmic patients in whom the oesophageal acid stimulus elicited cardiac autonomic reflexes. In these patients acid suppression seems to improve GERD and cardiac symptoms.

     

The effect of mosapride, a novel prokinetic, on acid reflux variables in patients with gastro-oesophageal reflux disease

Background:

Mosapride is a novel prokinetic agent facilitating acetylcholine release from the enteric cholinergic neurones through a selective 5-HT₄ receptor agonistic action. It is also active through its main metabolite M1, which is a 5-HT₃ antagonist. The importance of motor dysfunction in the pathogenesis of gastro-oesophageal reflux disease (GERD) makes it interesting to examine the effect of mosapride on oesophageal acid exposure.

Methods:

The effect of mosapride on oesophageal 24-h acid reflux variables was studied in 21 patients with GERD symptoms and a pre-entry total acid exposure time (pH < 4) of more than 5%. Ambulatory pH monitoring was performed after treatment with 40 mg mosapride citrate or placebo q.d.s. for 2 days in random order, using a double-blind crossover technique, with a washout period of at least 5 days.

Results:

Mosapride was significantly more effective than placebo in decreasing the total number of reflux episodes, the total number of reflux episodes lasting more than 5 min and the total time, as well as the amount of day time, of intra-oesophageal pH below 4. Consequently, mosapride also significantly improved total acid clearance time.

Conclusion:

Mosapride 40 mg q.d.s. is effective in decreasing acid reflux in the oesophagus in patients with GERD and therefore has the potential to be effective in the treatment of this disease.

     

Pantoprazole 20 mg is effective for relief of symptoms and healing of lesions in mild reflux oesophagitis

Aim:

To investigate the efficacy of a low dose of pantoprazole, a gastric proton pump inhibitor, for the relief of symptoms and healing of lesions in mild gastro-oesophageal reflux disease (GERD), and to compare it with the efficacy of ranitidine.

Methods:

Patients with endoscopically established GERD (Stage I, Savary–Miller classification) were enrolled into a randomized, double-blind, parallel-group and multicentre study (intention-to-treat n = 209, age range 19–82 years). They were treated once daily with oral pantoprazole 20 mg or ranitidine 300 mg, for up to 8 weeks. End-point parameters included relief of symptoms (heartburn, acid regurgitation, pain on swallowing) and the healing of GERD lesions. Relief from symptoms was assessed after 2 and 4 weeks, and endoscopically confirmed healing of lesions after 4 and 8 weeks.

Results:

The proportion of patients reporting complete relief from symptoms after 2 weeks was greater in the pantoprazole than in the ranitidine group (69 vs. 48%, P < 0.01), with further improvements seen in the pantoprazole group after 4 weeks (80 vs. 65%, P < 0.05, Cochran–Mantel/Haenszel test). Healing of lesions was confirmed in 70/87 (80%) patients after 4 weeks (pantoprazole group), as compared with 55/86 (64%) patients (ranitidine group) (P < 0.05, per protocol population); after 8 weeks the respective results were 78/87 (90%) and 63/86 (73%) patients (P < 0.01). Both study medications were well tolerated.

Conclusion:

Low-dose pantoprazole (20 mg) is clinically superior to ranitidine (300 mg) in providing fast relief from symptoms and healing of lesions in patients with mild GERD.

     

Work productivity loss in patients with dry eye disease: an online survey

Abstract

Objective:

To assess the impact of dry eye disease (DED) on productivity.     

Complexities in the pharmacologic management of osteoarthritis pain

Abstract

Objective:

To discuss challenges in the pharmacologic management of osteoarthritis (OA) pain.     

Relationship between background cancer pain,breakthrough pain,and analgesic treatment: a preliminary study for a better interpretation of epidemiological and clinical studies

Abstract

Background:

The different operational definitions of breakthrough cancer pain (BTcP) has generated unclear epidemiological data.     

Effect of fesoterodine 4 mg on bladder diary and patient-reported outcomes during the first week of treatment in subjects with overactive bladder

Abstract

Objective:

To assess the onset of efficacy of fesoterodine 4?mg versus placebo in subjects with overactive bladder (OAB) symptoms     

The intraocular pressure reducing effect of brinzolamide as adjunctive therapy to latanoprost

Abstract

Aim:

To determine the intraocular pressure (IOP) lowering effect of brinzolamide when added to latanoprost.     

Diabetic retinopathy: a new predictor in patients on regular hemodialysis

Abstract

Background:

Data evaluating the presence and impact of diabetic retinopathy (DR) in patients on regular hemodialysis (HD) are scarce.     

Measurement of utility values in the UK for health states related to immune thrombocytopenic purpura

Abstract

Objective:

To measure utility values associated with immune (idiopathic) thrombocytopenic purpura (ITP), as perceived by the United Kingdom (UK) general public.     

Intranasal ketorolac for acute postoperative pain

Abstract

Background:

Efficacy and tolerability of intranasal ketorolac (SPRIX®) was assessed in abdominal surgery patients.     

Treatment response and tolerability of frovatriptan in patients reporting short- or long-duration migraines at baseline

Abstract

Objectives:

Compare migraine duration with frovatriptan (versus baseline) in migraineurs reporting long- (24?72?h) or short-duration (<24?h) migraines at baseline.     

Retrospective analysis of variation in heavy menstrual bleeding treatments by age and underlying cause

Abstract

Objective:

To describe treatment patterns associated with heavy menstrual bleeding (HMB) in US practice.     

What do we know about the safety of corticosteroids in rheumatoid arthritis?

Abstract

Background:

Clear information is still lacking on the safety of corticosteroids (GCs) therapy in RA despite six decades of clinical experience.     

Efficacy and safety of celecoxib versus diclofenac and omeprazole in elderly arthritis patients: a subgroup analysis of the CONDOR trial

Abstract

Objective:

To compare the safety and efficacy of celecoxib versus diclofenac slow release (SR) plus omeprazole in elderly arthritis patients.     

Subcutaneous specific immunotherapy for seasonal allergic rhinitis: a review of treatment practices in the US and Europe

Abstract

Background:

Subcutaneous specific immunotherapy (SCIT) is claimed to be successful both in the US and Europe, yet treatment methodology differs.     

Observational,open-label study of type 1 and type 2 diabetes patients switching from human insulin to insulin analogue basal–bolus regimens: insights from the PREDICTIVE study

Abstract

Objective:

Evaluation of the safety and efficacy of insulin detemir (IDet) in the observational and non-interventional PREDICTIVE study.