title: Risk factors for resistance to proton pump inhibitor maintenance therapy for reflux esophagitis in Japanese women over 60 years.
abstract: OBJECTIVE
  The aim of this study was to evaluate risk factors for proton pump inhibitor (PPI) resistance in older Japanese female patients with reflux esophagitis evaluated by physicians.
  
  
  METHODS
  The study included 462 Japanese female patients aged over 60 years with reflux esophagitis who received PPI maintenance therapy for more than 6 months.
  
  
  RESULTS
  The characteristics of all 462 patients were: age: 76.4 ± 7.6 years, height: 147.2 ± 6.1 cm, weight: 49.9 ± 8.4 kg and body mass index: 24.0 ± 3.5. The reflux esophagitis grades were A in 69.5%, B in 15.8%, C in 9.1% and D in 5.6%. Helicobacter pylori was positive in 60.6%. Regarding PPI maintenance therapy for clinical symptoms evaluated by the attending physicians, 66.7% were 'good control', 26.8% were 'reasonable control' and 6.5% were 'bad control: resistant'. PPI maintenance therapy was less effective in patients with more severe reflux esophagitis of grades C and D (OR: 0.027; 95% CI: 0.010-0.077) and negative H. pylori infection status (OR: 4.470; 95% CI: 1.631-12.247). Lumbar kyphosis and hiatus hernia were risk factors for severity grading of reflux esophagitis.
  
  
  CONCLUSIONS
  PPI maintenance therapy evaluated by attending physicians indicated that reflux esophagitis severity and negative H. pylori status were risk factors for treatment resistance.
authors.affiliation: Department of Internal Medicine and Gastrointestinal Endoscopy, Saga Medical School, Saga, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Watanabe
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Iwakiri
authors.forename: Daisuke
authors.initials: D
authors.lastname: Yamaguchi
authors.forename: Toru
authors.initials: T
authors.lastname: Higuchi
authors.forename: Nanae
authors.initials: N
authors.lastname: Tsuruoka
authors.forename: Koichi
authors.initials: K
authors.lastname: Miyahara
authors.forename: Kayo
authors.initials: K
authors.lastname: Akutagawa
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Sakata
authors.forename: Takehiro
authors.initials: T
authors.lastname: Fujise
authors.forename: Yasutomo
authors.initials: Y
authors.lastname: Oda
authors.forename: Ryo
authors.initials: R
authors.lastname: Shimoda
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sakata
authors.forename: Kazuma
authors.initials: K
authors.lastname: Fujimoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D016001:Confidence Intervals; D004351:Drug Resistance; D004942:Esophagitis, Peptic / Q000150:complications / Q000188:drug therapy*; D005260:Female; D016481:Helicobacter Infections / Q000150:complications*; D016480:Helicobacter pylori; D006551:Hernia, Hiatal / Q000150:complications; D006801:Humans; D007564:Japan; D007738:Kyphosis / Q000150:complications; D008159:Lumbar Vertebrae; D060046:Maintenance Chemotherapy; D008875:Middle Aged; D016017:Odds Ratio; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D054328:Proton Pump Inhibitors