PMID- 21083590
OWN - NLM
STAT- MEDLINE
DCOM- 20110506
LR  - 20131121
IS  - 1365-2036 (Electronic)
IS  - 0269-2813 (Linking)
VI  - 33
IP  - 1
DP  - 2011 Jan
TI  - Randomised clinical trial: identification of responders to short-term treatment 
      with esomeprazole for dyspepsia in primary care - a randomised, 
      placebo-controlled study.
PG  - 41-9
LID - 10.1111/j.1365-2036.2010.04501.x [doi]
AB  - BACKGROUND: Response to proton pump inhibitor (PPI) treatment in dyspepsia is 
      unpredictable. AIM: To identify symptoms associated with response to esomeprazole 
      in order to target patients for empirical treatment. METHODS: Eight hundred and 
      five uninvestigated, primary care patients with upper GI symptoms that were 
      considered to be acid-related were randomised to 2 weeks' treatment with 
      esomeprazole 40 mg or placebo. The study population was divided into a model 
      sample (N = 484) and a validation sample (N = 321). We developed a therapeutic 
      index to predict PPI response from the model sample and tested this in the 
      validation sample. RESULTS: Response to PPI was found in 68% of patients (44% in 
      placebo arm). Bothersome heartburn and early satiety were associated with 
      increased likelihood of PPI response, whereas dull abdominal pain, pain relieved 
      by bowel movements and nausea in women were associated with a decreased 
      likelihood of PPI response. Patients in the validation sample could be classified 
      as having a 'very high' (n = 55), 'high' (n = 123), 'medium' (n = 78) or 'low' (n 
      = 65) probability of PPI response. The therapeutic gains over placebo were 55%, 
      31%, 20% and 22%, respectively. CONCLUSIONS: In patients with uninvestigated 
      dyspepsia, PPI responders can be reliably identified by a simple pocket chart 
      using symptoms and patient characteristics (ClinicalTrials.gov NCT00318968).
CI  - (c) 2010 Blackwell Publishing Ltd.
FAU - Meineche-Schmidt, V
AU  - Meineche-Schmidt V
AD  - Department of General Practice, The Panum Institute, University of Copenhagen, 
      Denmark.
FAU - Christensen, E
AU  - Christensen E
FAU - Bytzer, P
AU  - Bytzer P
LA  - eng
SI  - ClinicalTrials.gov/NCT00318968
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20101029
PL  - England
TA  - Aliment Pharmacol Ther
JT  - Alimentary pharmacology & therapeutics
JID - 8707234
RN  - 0 (Anti-Ulcer Agents)
RN  - 0 (Proton Pump Inhibitors)
RN  - N3PA6559FT (Esomeprazole)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anti-Ulcer Agents/*therapeutic use
MH  - Dyspepsia/*drug therapy
MH  - Esomeprazole/administration & dosage/*therapeutic use
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Primary Health Care
MH  - Proton Pump Inhibitors/administration & dosage/*therapeutic use
MH  - Regression Analysis
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2010/11/19 06:00
MHDA- 2011/05/07 06:00
CRDT- 2010/11/19 06:00
PHST- 2010/11/19 06:00 [entrez]
PHST- 2010/11/19 06:00 [pubmed]
PHST- 2011/05/07 06:00 [medline]
AID - 10.1111/j.1365-2036.2010.04501.x [doi]
PST - ppublish
SO  - Aliment Pharmacol Ther. 2011 Jan;33(1):41-9. doi: 
      10.1111/j.1365-2036.2010.04501.x. Epub 2010 Oct 29.