Influence of Age on Treatment with Proton Pump Inhibitor in Patients with Laryngopharyngeal Reflux Disease

Abstract

Objectives: The influence of age in severity and response to proton pump inhibitor (PPI) in patients with laryngopharyngeal reflux (LPR) is unclear. Thus, we conducted a prospective cohort study to assess the difference in severity and response to PPI according to age in patients with LPR. Methods: Two hundred twenty-nine patients with LPR who were referred to the otolaryngology clinic from November 2010 to February 2012 were enrolled in the study. All of the enrolled patients were prescribed 15mg of Lansoprazole (PPI) twice daily for three months. Data, including the Reflux Symptom Index (RSI), Reflux Finding Score (RFS), and LPR-Health related quality of life (LPR-HRQOL), were collected from patients at the baseline visit and at 1 and 3 months post-baseline. Results: The older patients group (60-79 years) showed a higher score in RSI ( P < 0.001) and LPR-HRQOL (p<0.001) at baseline than the younger subgroups. However, the RFS score showed no significant difference among age subgroups. Within each age subgroup, RSI, RFS, and LPR-HRQOL showed significant improvement with PPI therapy; however, no difference in improvement of RSI, RFS, or LPR-HRQOL was seen among the subgroups. The responders who had changes in RSI score at three months were found significantly more often in the younger group than the older group ( P = 0.002). Conclusions: Age appears to affect the subjective symptoms and resulting impact on their QOL but not laryngeal finding in patients with LPR. Furthermore, the clinician should be aware that older patients are more likely to not respond to PPI.