The effect of esomeprazole 20 mg twice daily on acoustic and perception parameters of the voice in laryngopharyngeal reflux.
BACKGROUND
Randomized, placebo-controlled studies have failed to demonstrate a significant treatment effect for laryngopharyngeal reflux (LPR) using traditional clinical endpoints. We compared the effect of esomeprazole 20 mg twice daily (b.i.d.) vs placebo on voice and acoustic-related measures in patients with LPR.


METHODS
Patients with LPR underwent endoscopy and pH testing. Subsequently, patients underwent videostroboscopic recordings of the larynx, acoustic voice and speech analysis. A voice use and quality diary and oesophageal symptom diary were completed at baseline. Thereafter, patients were randomized to esomeprazole 20 mg twice daily vs placebo for 3 months. The voice use and quality diary and oesophageal symptom dairy were repeated during the last week of treatment. Videostroboscopy and acoustic voice and speech analysis were also performed at the end of treatment.


RESULTS
Twenty-four patients were randomized to the esomeprazole group and 17 to the placebo group. There was no significant difference in videostroboscopic reflux finding scores from baseline to post-treatment. Acoustic measures also failed to demonstrate significant differences within the same or between groups, even when a sub-group analysis of patients with endoscopically documented oesophageal inflammation at baseline was performed. Additionally, no significant differences were found between groups when using voice use and quality diary.


CONCLUSIONS
Use of more specific laryngeal functional parameters such as voice-related acoustic measures of pitch range, fundamental frequency and intensity also failed to demonstrate a significant response to proton pump inhibitor treatment as compared to placebo in patients with suspected LPR.
Fass
R
R
The Neuroenteric Clinical Research Group, Southern Arizona VA Health Care System and University of Arizona Health Sciences Center, Tucson, AZ 85723-0001, USA. ronnie.fass@va.gov
Noelck
N
N
Willis
M R
MR
Navarro-Rodriguez
T
T
Wilson
K
K
Powers
J
J
Barkmeier-Kraemer
J M
JM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004724:Endoscopy; D064098:Esomeprazole / Q000008:administration & dosage*; D050782:Esophageal pH Monitoring; D005260:Female; D006304:Health Status; D006801:Humans; D057045:Laryngopharyngeal Reflux / Q000188:drug therapy*; D007828:Laryngoscopy; D007830:Larynx / Q000187:drug effects* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D054328:Proton Pump Inhibitors / Q000008:administration & dosage; D011788:Quality of Life; D013061:Speech Acoustics; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014833:Voice Quality / Q000187:drug effects
D054328:Proton Pump Inhibitors; D064098:Esomeprazole