title: Factors affecting response to proton pump inhibitor therapy in patients with gastroesophageal reflux disease: a multicenter prospective observational study.
abstract: BACKGROUND
  Proton pump inhibitor (PPI) therapy, the first-line treatment for gastroesophageal reflux disease (GERD), is not always effective. This study aimed to examine the effect of pretreatment patient characteristics on response to PPI therapy.
  
  
  METHODS
  Japanese outpatients with symptomatic GERD scheduled to receive endoscopy and PPI therapy were enrolled in this multicenter prospective observational study. The patients' characteristics, including GERD and dyspeptic symptoms, anxiety, depression, and quality of life, were assessed using questionnaires before and 2 and 4 weeks after the start of PPI therapy. Factors affecting therapeutic response were examined by simple and multiple regression analyses using three patient-reported outcome measures as objective variables.
  
  
  RESULTS
  Data from 182 patients were analyzed. In multiple regression analysis using the residual symptom rate as an objective variable, lower GERD symptom score (p < 0.05), absence of erosive esophagitis (p < 0.05), higher epigastric pain/burning symptom score (p < 0.05), and higher depression subscale score (p < 0.05) accompanied poorer therapeutic response. In analyses using the patient's impression of therapy, lower GERD symptom score (p < 0.05) and absence of erosive esophagitis (p < 0.05) accompanied poorer therapeutic response. In analyses using the relative GERD symptom intensity evaluated using a numeric rating scale, lower GERD symptom score (p < 0.05), higher epigastric pain/burning symptom score (p < 0.1), and lower body mass index (p < 0.05) accompanied poorer therapeutic response.
  
  
  CONCLUSIONS
  Patients who complained of milder GERD symptoms before treatment were likely to have poorer response to PPI therapy. Association of absence of erosive esophagitis, severer epigastric pain/burning symptoms, lower body mass index, and severer depression with poorer therapeutic response was also suggested.
authors: Department of Gastroenterology, NTT Medical Center Tokyo, 5-9-22 Higashi-Gotanda, Shinagawa-ku, Tokyo, 141-8625, Japan.
authors: Nobuyuki
authors: N
authors: Matsuhashi
authors: Department of Gastroenterology, Sapporo Hokuyu Hospital, 6-5-1 Higashisapporo 6-jo, Shiroishi-ku, Sapporo, Hokkaido, 003-0006, Japan.
authors: Mineo
authors: M
authors: Kudo
authors: Department of Gastroenterology, Japanese Red Cross Kyoto Daiichi Hospital, 15-749 Hommachi, Higashiyama-ku, Kyoto, 605-0981, Japan.
authors: Norimasa
authors: N
authors: Yoshida
authors: Department of Gastroenterology, Oita University Hospital, 1-1 Hasamamachi Idaigaoka, Yufu, Oita, 879-5593, Japan.
authors: Kazunari
authors: K
authors: Murakami
authors: Division of Endoscopy, Hokkaido University Hospital, 5-chome, Kita14-jo Nishi, Kita-ku, Sapporo, Hokkaido, 060-8648, Japan.
authors: Mototsugu
authors: M
authors: Kato
authors: Department of Gastroenterology, Kita Harima Medical Center, 926-250 Ichiba, Ono, Hyogo, 675-1392, Japan.
authors: Tsuyoshi
authors: T
authors: Sanuki
authors: Faculty of Letters, Arts and Sciences, Waseda University, 1-24-1 Toyama, Shinjuku-ku, Tokyo, 162-8644, Japan.
authors: Atsushi
authors: A
authors: Oshio
authors: Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi Mizuhocho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan.|GERD Society Study Committee, 2-2-2 Nakanoshima, Kita-ku, Osaka, 530-0005, Japan.
authors: Takashi
authors: T
authors: Joh
authors: GERD Society Study Committee, 2-2-2 Nakanoshima, Kita-ku, Osaka, 530-0005, Japan.|Second Department of Internal Medicine, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan.
authors: Kazuhide
authors: K
authors: Higuchi
authors: GERD Society Study Committee, 2-2-2 Nakanoshima, Kita-ku, Osaka, 530-0005, Japan.|Division of Gastroenterology, Department of Internal Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan.
authors: Ken
authors: K
authors: Haruma
authors: GERD Society Study Committee, 2-2-2 Nakanoshima, Kita-ku, Osaka, 530-0005, Japan. nakada@jikei.ac.jp.|Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishishimbashi, Minato-ku, Tokyo, 105-8461, Japan. nakada@jikei.ac.jp.
authors: Koji
authors: K
authors: Nakada
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D001007:Anxiety / Q000523:psychology; D003863:Depression / Q000523:psychology; D004415:Dyspepsia / Q000188:drug therapy; D005260:Female; D005764:Gastroesophageal Reflux / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D012720:Severity of Illness Index; D017678:Sex Distribution; D016896:Treatment Outcome
chemical_list: D054328:Proton Pump Inhibitors
keywords: Anxiety; Depression; Dyspeptic symptoms; Gastroesophageal reflux disease; Therapeutic response to proton pump inhibitor therapy