Predictors of Early and Late Response to Esomezol and Lifestyle Modification in Adults With Laryngopharyngeal Reflux Disease: A Prospective, Multicenter, Open-Label Cohort Study

被引：1

作者：

Kwon, Seong Keun ^{[1
]}

Park, Sung Joon ^{[2
]}

Chung, Eun-Jae ^{[1
]}

Sohn, Jin-Ho ^{[3
]}

Sun, Dong-Il ^{[4
]}

Lee, Byung-Joo ^{[5
,6
]}

Park, Il-Seok ^{[7
]}

Cho, Jae-Gu ^{[8
]}

Park, Young Hak ^{[9
]}

机构：

[1] Seoul Natl Univ, Seoul Natl Univ Hosp, Dept Otorhinolaryngol Head & Neck Surg, Coll Med, Seoul, South Korea

[2] Chung Ang Univ, Gwangmyeong Hosp, Dept Otorhinolaryngol Head & Neck Surg, Coll Med, Gwangmyeong, South Korea

[3] Kyungpook Natl Univ, Chilgok Hosp, Sch Med, Dept Otolaryngol Head & Neck Surg, Daegu, South Korea

[4] Catholic Univ Korea, Seoul St Marys Hosp, Coll Med, Dept Otorhinolaryngol Head & Neck Surg, Seoul, South Africa

[5] Sungkyunkwan Univ, Kangbuk Samsung Hosp, Dept Otorhinolaryngol Head & Neck Surg, Sch Med, Seoul, South Korea

[6] Pusan Natl Univ, Pusan Natl Univ Hosp, Dept Otorhinolaryngol Head & Neck Surg, Sch Med, Busan, South Korea

[7] Hallym Univ, Dongtan Sacred Heart Hosp, Dept Otorhinolaryngol Head & Neck Surg, Coll Med, Suwon, South Korea

[8] Korea Univ, Coll Med, Dept Otorhinolaryngol Head & Neck Surg, Guro Hosp, Seoul, South Korea

[9] Catholic Univ Korea, Yeouido St Marys Hosp, Coll Med, Dept Otorhinolaryngol Head & Neck Surg, 10 63 Yuksam Ro, Seoul, South Korea

来源：

CLINICAL AND EXPERIMENTAL OTORHINOLARYNGOLOGY | 2023年 / 16卷 / 03期

关键词：

Laryngopharyngeal Reflux; Proton Pump Inhibitors; Life Style Modification; Predictive Factor; Patient Compliance; Patient Medi-cal History; Medication History; PUMP INHIBITOR THERAPY; RABEPRAZOLE; PREVALENCE; MANAGEMENT; SYMPTOMS; TRIAL;

D O I：

10.21053/ceo.2023.00409

中图分类号：

R76 [耳鼻咽喉科学];

学科分类号：

100213 ;

摘要：

Objectives. This study aimed to assess predictors of the response to varying durations of proton pump inhibitor (PPI) use and lifestyle modification treatment for laryngopharyngeal reflux disease (LPRD). Methods. Between October 2014 and June 2016, a prospective, multicenter, open-label, single-cohort, intention-to-treat, observational study was conducted at eight referral hospitals across the Republic of Korea to examine predictors of early and late response to treatment in adult patients (age & GE;19 years) with LPRD. Participants underwent standard treatment (PPI [Esomezol] and lifestyle modification) for 3 months. Response to treatment was defined as greater than 50% improvement in reflux symptom index score. The primary outcome was potential predictors of treatment re-sponse at 1 and 3 months. The secondary outcome was potential predictors distinguishing early from late responders. Results. In total, 394 patients were enrolled. Improved sleep habits was a positive predictor (odds ratio [OR], 1.785; 95% confidence interval [CI], 1.06-3.007; P=0.029), while initial alcohol consumption (OR, 0.587; 95% CI, 0.355-0.969; P= 0.037) and past medication history (OR, 0.438; 95% CI, 0.215-0.891; P= 0.005) were negative predictors of re-sponse after 1 month of treatment. High pre-reflux finding score was a positive predictor (OR, 1.187; 95% CI, 1.049- 1.344; P= 0.007), while male sex (OR, 0.516; 95% CI, 0.269-0.987; P= 0.046), higher depression score (OR, 0.867; 95% CI, 0.784-0.958; P= 0.005), and past thyroid hormone medication history (OR, 0.161; 95% CI, 0.033-0.788; P=0.024) were negative predictors of response after 3 months of treatment. Past medication history (OR, 0.438; 95% CI, 0.215-0.891; P=0.023) was the only negative predictor for early responders compared to late responders. Conclusion. Adult patients with LPRD and a history of prior medication use may require longer treatment durations to achieve a therapeutic response. Future research should explore the incorporation of diverse treatment approaches to improve treatment outcomes for patients exhibiting negative prognostic indicators.

引用

页码：259 / 274

页数：16

共 29 条

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