W1088 Predictors of Improvement in Associated Symptoms With Rabeprazole Treatment in Patients With Nonerosive Gastroesophageal Reflux Disease (GERD)

Abstract

moderate/severe GERD symptoms on ≥ 1 day a week). Sample-size weighted means and 95% confidence intervals (CI) were calculated for all pooled prevalence data. Potential determinants of partialand non response were examined in Poisson regression analysis. Results: Eighteen studies, including 18 667 individuals, were eligible for inclusion. Most studies had a minimum duration of PPI therapy of 4 weeks, and reported only combined data for partialand non-response. In interventional, non-randomized primary care trials, 27% (95% CI: 17-37%) of patients with GERD had any heartburn and 25% (95% CI: 1535%) had any regurgitation while on PPI therapy; troublesome heartburn or regurgitation was reported by 12% (95% CI: 4-20%) and 29% (one study) of patients, respectively. In interventional, randomized primary care trials, 52% (95% CI: 47-57%) of patients had any heartburn and 52% (95%CI: 43-61%) had any regurgitation despite PPI therapy; troublesome heartburn or regurgitation was reported by 32% (95% CI: 26-38%) and 28% (95% CI: 2630%) of patients, respectively. Observational communityand primary care-based studies had a higher prevalence of partialand non-response to PPI therapy (any GERD symptoms 50%; 95% CI: 42-58%; troublesome GERD symptoms 62%; 95% CI: 61-63%). Studies that had > 60% female participants (vs < 60%) and those that were conducted in North America (vs Europe or Australia) reported higher rates of partialor non-response. Partialor non-response to PPI therapy was associated with decreased psychological and physical well-being. Conclusions: At least 30% of patients on PPI therapy in primary care trials, and 50-60% of individuals using PPIs in the community, have troublesome GERD symptoms despite PPI therapy. Alternative approaches to management are required.