Serum pepsinogen can predict response to H2-receptor antagonist in patients with functional dyspepsia.
BACKGROUND
Therapy for the relief of symptoms of functional dyspepsia is unpredictable.


OBJECTIVE
To identify which patients may benefit from antisecretory therapy.


METHODS
Twenty-seven patients with functional dyspepsia were selected to receive H2-receptor antagonist (H2RA) treatment for 4 weeks. Serum pepsinogen A, pepsinogen C and gastrin were measured, and Helicobacter pylori status was determined. Symptoms were assessed at baseline and after H2RA treatment.


RESULTS
Fourteen patients were identified as H2RA responders and the remaining patients were non-responders. No differences were found between responders and non-responders with regard to serum pepsinogen A, pepsinogen C, gastrin and H. pylori status. However, the pepsinogen A/C ratio was significantly higher in responders than in non-responders. Ten of the 13 functional dyspepsia patients (77%) with a high value of the pepsinogen A/C ratio (> or = 4.5) achieved symptom resolution by H2RA, compared with only one of the eight patients (13%) with a low value of the pepsinogen A/C ratio (< or = 3.0).


CONCLUSIONS
The serum pepsinogen A/C ratio seems to identify those functional dyspepsia patients for whom acid control provides benefit. This ratio may be a practical tool for the management of functional dyspepsia patients.
Yoshikawa
I
I
Third Department of Internal Medicine, University of Occupational and Environmental Health, Japan, School of Medicine, Kitakyushu, Japan.
Murata
I
I
Kume
K
K
Kanagawa
K
K
Hirohata
Y
Y
Nakamura
H
H
Otsuki
M
M
D000328:Adult; D000368:Aged; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D004415:Dyspepsia / Q000097:blood / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D005755:Gastrins / Q000097:blood; D016480:Helicobacter pylori / Q000302:isolation & purification; D006635:Histamine H2 Antagonists / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D020116:Pepsinogen A / Q000097:blood*; D020115:Pepsinogen C / Q000097:blood; D010880:Piperidines / Q000627:therapeutic use*; D016896:Treatment Outcome
D000897:Anti-Ulcer Agents; D015415:Biomarkers; D005755:Gastrins; D006635:Histamine H2 Antagonists; D010880:Piperidines; D020115:Pepsinogen C; D020116:Pepsinogen A; C053742:roxatidine acetate