Abstract
Purpose: To test for an association of race with healing of different grades of EE in GERD patients treated with once-daily PPIs. Methods: This post hoc analysis pooled data from 5 similarly designed, double-blind, multicenter RCTs of esomeprazole 40 mg vs omeprazole 20 mg (SH-QBE-0013, −0016, −0052) or lansoprazole 30 mg (D9612C00083, D9612L00046) for EE healing. Eligible adults had endoscopically verified EE, graded using the Los Angeles (LA) classification system. PPIs were given 30–60 min before breakfast. Endoscopy was repeated at wk 4 and 8 to assess EE status; patients healed (ie, no mucosal breaks) at wk 4 exited the study. EE healing rates are tabulated below by baseline LA grade (A-D) and self-reported race data (white or nonwhite [ie, all other reported races]). A proportional odds model tested for an association of race with baseline LA grade. Logistic regression models (LRMs) were fit with EE healing as the dependent variable and race as an independent variable. The LRM adjusted for treatment, study, baseline LA grade, age, sex, BMI, H pylori status, and hiatal hernia. A second LRM tested for interaction of race with the other factors. Results: Mean age of the 11,027 patients was 47 y (59% men; 91% white). Nonwhite patients had less severe baseline EE (ie, LA grades A or B) (P < .0001; adjusted odds ratio [OR], 0.69 [95% CI, 0.61–0.79]). Race had a significant effect on wk-8 EE healing (P= .001; OR [nonwhite vs white], 0.75 [95% CI, 0.63–0.89]; Table). Less severe baseline LA grade, treatment, and increasing age (P < .0001 for each) and hiatal hernia (P= .0009) were associated with higher odds of EE healing; these factors had no significant interactions with race. Conclusion: After adjustment for treatment, study, baseline LA grade, age, sex, BMI, H pylori status, and hiatal hernia, nonwhite patients were less likely to have healed EE after 8-wk PPI therapy, a finding worthy of further study.Table. EE: healing rates (95% CI) by race and baseline LA grade (N = 11,027)
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