title: Combination of angiotensin II receptor blockers promotes proton pump inhibitor-based healing of reflux esophagitis.
abstract: BACKGROUND
  Several studies have described factors associated with the failure of proton pump inhibitors (PPIs) to effect endoscopic healing of reflux esophagitis (RE), but few studies have addressed factors promoting PPI-based endoscopic healing. We performed post hoc analysis of a multicenter prospective cohort of RE patients to identify factors encouraging endoscopic healing of this disorder.
  
  
  METHODS
  Patients with RE received 10 or 20 mg rabeprazole for 8 weeks, and endoscopic findings before and after treatment were studied. To evaluate the effects of patient background factors on endoscopic healing, we performed multiple logistic regression analysis and determined the respective odds ratios (ORs) and 95% confidence intervals (CIs).
  
  
  RESULTS
  A total of 454 patients who underwent endoscopy at baseline and again at week 8 were included in the analysis. After 8 weeks of treatment, improvement in endoscopic findings was observed in 94.1% (427/454) of patients, and endoscopic healing was seen in 76.7% (348/454). Multiple logistic regression analysis revealed that a combination of angiotensin II receptor blockers (ARBs) had a significant positive impact on endoscopic healing (OR 3.9, 95% CI 1.411-10.903), but no significant positive relationship was seen for other concomitant drugs such as nonsteroidal anti-inflammatory drugs and calcium channel blockers. Severe RE at baseline (OR 0.365, 95% CI 0.281-0.475) and PPI therapy prior to enrollment (OR 0.154, 95% CI 0.052-0.453) were found to have significant negative effects on endoscopic healing.
  
  
  CONCLUSIONS
  Concomitant use of ARBs may promote endoscopic healing of RE treated with PPIs.
authors: Division of Upper Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan. miwahgi@hyo-med.ac.jp
authors: Hiroto
authors: H
authors: Miwa
authors: Michio
authors: M
authors: Hongo
authors: Motoyasu
authors: M
authors: Kusano
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000008:administration & dosage / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000368:Aged; D057911:Angiotensin Receptor Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000008:administration & dosage / Q000627:therapeutic use; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D004942:Esophagitis, Peptic / Q000188:drug therapy* / Q000473:pathology; D004945:Esophagoscopy; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D064750:Rabeprazole; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D057911:Angiotensin Receptor Antagonists; D000894:Anti-Inflammatory Agents, Non-Steroidal; D002121:Calcium Channel Blockers; D054328:Proton Pump Inhibitors; D064750:Rabeprazole