Lansoprazole treatment of patients with chronic idiopathic laryngitis: a placebo-controlled trial.
OBJECTIVE
Previous uncontrolled studies suggested a therapeutic benefit for treating gastroesophageal reflux disease (GERD) among patients with laryngitis. The present study is the first randomized, placebo-controlled, double-blind study of gastric acid suppression among patients with laryngitis in the United States.


METHODS
Patients diagnosed with idiopathic chronic laryngitis were randomized to receive either lansoprazole 30 mg p.o. b.i.d. or a matching placebo for 3 months. Before randomization, all patients underwent upper endoscopy, dual probe ambulatory 24-h esophageal pH-metry, and laryngoscopy, as well as completing a symptom questionnaire for GERD and laryngitis. The primary outcome of treatment was the complete resolution of laryngeal symptoms.


RESULTS
A total of 22 patients with symptoms and signs of chronic laryngitis were enrolled, 20 of whom completed the study. At baseline, there were no significant differences between the two groups with regards to GERD symptoms, erosive esophagitis, proximal and distal esophageal pH-metry, or laryngeal signs and symptoms. In an intention-to-treat analysis, six patients in the lansoprazole group (50%) and only one patient (10%) in the placebo group achieved a complete symptomatic response, p = 0.04. Apart from receiving lansoprazole, there were no significant differences between responders and nonresponders in any of baseline esophageal or laryngeal signs and symptoms.


CONCLUSIONS
Empirical treatment with lansoprazole is efficacious in relieving symptoms of laryngitis compared to placebo. Such treatment can be considered as a first-line option in managing patients with idiopathic chronic laryngitis.
El-Serag
H B
HB
Division of Gastroenterology, Houston VA Medical Center and Baylor College of Medicine, Texas 77030, USA.
Lee
P
P
Buchner
A
A
Inadomi
J M
JM
Gavin
M
M
McCarthy
D M
DM
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000368:Aged; D002908:Chronic Disease; D004311:Double-Blind Method; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications; D006801:Humans; D064747:Lansoprazole; D007827:Laryngitis / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D054328:Proton Pump Inhibitors
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D054328:Proton Pump Inhibitors; D064747:Lansoprazole; D009853:Omeprazole