In-practice predictors of response to proton pump inhibitor therapy in primary care patients with dyspepsia in an Asian population.
BACKGROUND
Data on Asian patients who present to primary care physicians with dyspepsia are limited.


OBJECTIVE
To determine predictors of response to a trial of proton pump inhibitor therapy.


METHODS
One hundred ninety patients presenting to their general practitioners with dyspeptic symptoms but without alarm symptoms, underwent endoscopy and were subsequently treated with 20 mg of esomeprazole twice a day for 2 weeks. Possible predictors of response were assessed before treatment. Dyspeptic symptoms were scored at baseline and at the end of treatment. Excellent response and poor response were defined as end of treatment score of <or=1 and failure to achieve >or=50% reduction in symptom scores.


RESULTS
On bivariate analysis male sex and having <or=2 concurrent dyspeptic symptoms predicted excellent response, whereas bloating as most bothersome symptom, >2 dyspeptic symptoms, anxiety, and irritable bowel syndrome predicted poor response. On multivariate analysis, male sex and <or=2 dyspeptic symptoms, and bloating remained significant predictors of excellent and poor responses, respectively.


CONCLUSIONS
Predictors of response to proton pump inhibitor trial that could be easily assessed in a primary care clinic were identified. In our population the response was not as favorable as suggested by clinical trials. Frequent overlap with irritable bowel syndrome seems to be an important factor.
Gwee
Kok-Ann
KA
Department of Medicine, National University of Singapore, Singapore. gwee_kok_ann@nus.edu.sg
Hwang
Joel Ern-Huei
JE
Ho
Khek-Yu
KY
Yeoh
Khay-Guan
KG
Lum
Chun-Fatt
CF
Ang
Poh-Kit
PK
D000328:Adult; D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data; D004415:Dyspepsia / Q000188:drug therapy* / Q000453:epidemiology* / Q000517:prevention & control; D064098:Esomeprazole / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D012720:Severity of Illness Index; D016896:Treatment Outcome
D054328:Proton Pump Inhibitors; D064098:Esomeprazole