PMID- 23560727
OWN - NLM
STAT- MEDLINE
DCOM- 20131211
LR  - 20151119
IS  - 1365-2036 (Electronic)
IS  - 0269-2813 (Linking)
VI  - 37
IP  - 10
DP  - 2013 May
TI  - Reflux episodes detected by impedance in patients on and off esomeprazole: a 
      randomised double-blinded placebo-controlled crossover study.
PG  - 1011-8
LID - 10.1111/apt.12301 [doi]
AB  - BACKGROUND: Combined with 24-h pH monitoring, the use of impedance is the most 
      sensitive method available for detecting oesophageal reflux. Normal values for 
      impedance have been previously established in healthy controls studied on and off 
      proton pump inhibitors (PPI). AIMS: To determine the effects of PPIs on the total 
      number of reflux episodes in the distal oesophagus measured by impedance in 
      patients with and without gastro-oesophageal reflux disease (GERD). METHODS: In 
      this prospective randomised double-blinded placebo controlled crossover study, 
      all patients underwent two 24-h pH with impedance studies at least 2 weeks apart. 
      Based on a randomisation scheme, patients received either 40 mg of esomeprazole 
      twice daily for 1 week or identical capsule placebo for 1 week, then all patients 
      were crossed over to the other treatment arm. GERD was defined by the validated 
      Johnson-DeMeester score. Reflux by impedance was defined as a 50% decrease from 
      baseline in retrograde movement of liquid between two impedance sites. RESULTS: 
      Sixty-three patients were enrolled and 41 patients completed the study [mean age 
      52 +/- 12 years, 42% (17/41) men, 56% (23/41) Caucasian and 34% (14/41) African 
      American]. Overall, there was no significant decrease in the total number of 
      distal impedance episodes with esomeprazole compared with placebo (mean change 
      6.1 +/- 22, P = 0.100). When analysed separately by GERD status, among 
      GERD-positive patients, there was a significant decrease in distal impedance 
      episodes while on esomeprazole compared with placebo (mean change -16 +/- 22, P = 
      0.023), but not in GERD-negative patients (mean change -0.35 +/- 20, P = 0.872). 
      CONCLUSION: Esomeprazole decreases significantly the number of reflux episodes 
      detected by impedance, but only in patients with GERD.
CI  - Published 2013. This article is a US Government work and is in the public domain 
      in the USA.
FAU - Moawad, F J
AU  - Moawad FJ
AD  - Department of Medicine, Gastroenterology Service, Walter Reed National Military 
      Medical Center, Bethesda, MD 20889, USA. Fouad.Moawad@us.army.mil
FAU - Betteridge, J D
AU  - Betteridge JD
FAU - Boger, J A
AU  - Boger JA
FAU - Cheng, F-K F
AU  - Cheng FK
FAU - Belle, L S
AU  - Belle LS
FAU - Chen, Y-J
AU  - Chen YJ
FAU - Maydonovitch, C L
AU  - Maydonovitch CL
FAU - Wong, R K H
AU  - Wong RK
LA  - eng
SI  - ClinicalTrials.gov/NCT01710800
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20130407
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  - Adult
MH  - Anti-Ulcer Agents/*therapeutic use
MH  - Cross-Over Studies
MH  - Double-Blind Method
MH  - Electric Impedance
MH  - Esomeprazole/*therapeutic use
MH  - *Esophageal pH Monitoring
MH  - Female
MH  - Gastroesophageal Reflux/diagnosis/*drug therapy/physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Proton Pump Inhibitors/therapeutic use
MH  - Treatment Outcome
EDAT- 2013/04/09 06:00
MHDA- 2013/12/16 06:00
CRDT- 2013/04/09 06:00
PHST- 2013/02/13 00:00 [received]
PHST- 2013/03/06 00:00 [revised]
PHST- 2013/03/13 00:00 [revised]
PHST- 2013/03/13 00:00 [accepted]
PHST- 2013/04/09 06:00 [entrez]
PHST- 2013/04/09 06:00 [pubmed]
PHST- 2013/12/16 06:00 [medline]
AID - 10.1111/apt.12301 [doi]
PST - ppublish
SO  - Aliment Pharmacol Ther. 2013 May;37(10):1011-8. doi: 10.1111/apt.12301. Epub 2013 
      Apr 7.