PMID- 37350172 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230904 IS - 1976-8710 (Print) IS - 2005-0720 (Electronic) IS - 1976-8710 (Linking) VI - 16 IP - 3 DP - 2023 Aug TI - Predictors of Early and Late Response to Esomezol and Lifestyle Modification in Adults With Laryngopharyngeal Reflux Disease: A Prospective, Multicenter, Open-Label Cohort Study. PG - 259-274 LID - 10.21053/ceo.2023.00409 [doi] AB - OBJECTIVES: This study aimed to assess predictors of the response to varying durations of proton pump inhibitor (PPI) use and lifestyle modification treatment for laryngopharyngeal reflux disease (LPRD). METHODS: Between October 2014 and June 2016, a prospective, multicenter, open-label, single-cohort, intention-to-treat, observational study was conducted at eight referral hospitals across the Republic of Korea to examine predictors of early and late response to treatment in adult patients (age >/=19 years) with LPRD. Participants underwent standard treatment (PPI [Esomezol] and lifestyle modification) for 3 months. Response to treatment was defined as greater than 50% improvement in reflux symptom index score. The primary outcome was potential predictors of treatment response at 1 and 3 months. The secondary outcome was potential predictors distinguishing early from late responders. RESULTS: In total, 394 patients were enrolled. Improved sleep habits was a positive predictor (odds ratio [OR], 1.785; 95% confidence interval [CI], 1.06-3.007; P=0.029), while initial alcohol consumption (OR, 0.587; 95% CI, 0.355-0.969; P=0.037) and past medication history (OR, 0.438; 95% CI, 0.215-0.891; P=0.005) were negative predictors of response after 1 month of treatment. High pre-reflux finding score was a positive predictor (OR, 1.187; 95% CI, 1.049- 1.344; P=0.007), while male sex (OR, 0.516; 95% CI, 0.269-0.987; P=0.046), higher depression score (OR, 0.867; 95% CI, 0.784-0.958; P=0.005), and past thyroid hormone medication history (OR, 0.161; 95% CI, 0.033-0.788; P=0.024) were negative predictors of response after 3 months of treatment. Past medication history (OR, 0.438; 95% CI, 0.215-0.891; P=0.023) was the only negative predictor for early responders compared to late responders. CONCLUSION: Adult patients with LPRD and a history of prior medication use may require longer treatment durations to achieve a therapeutic response. Future research should explore the incorporation of diverse treatment approaches to improve treatment outcomes for patients exhibiting negative prognostic indicators. FAU - Kwon, Seong Keun AU - Kwon SK AD - Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. FAU - Park, Sung Joon AU - Park SJ AD - Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong, Korea. FAU - Chung, Eun-Jae AU - Chung EJ AD - Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. FAU - Sohn, Jin-Ho AU - Sohn JH AD - Department of Otolaryngology-Head and Neck Surgery, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea. FAU - Sun, Dong-Il AU - Sun DI AD - Department of Otorhinolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. FAU - Jin, Sung Min AU - Jin SM AD - Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. FAU - Lee, Byung-Joo AU - Lee BJ AD - Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea. FAU - Park, Il-Seok AU - Park IS AD - Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Suwon, Korea. FAU - Cho, Jae-Gu AU - Cho JG AD - Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea. FAU - Park, Young Hak AU - Park YH AD - Department of Otorhinolaryngology-Head and Neck Surgery, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. LA - eng GR - HM-IIT-ESO-004/Hanmi Pharmaceutical Co. Ltd/ PT - Journal Article DEP - 20230619 PL - Korea (South) TA - Clin Exp Otorhinolaryngol JT - Clinical and experimental otorhinolaryngology JID - 101474010 PMC - PMC10471909 OTO - NOTNLM OT - Laryngopharyngeal Reflux OT - Life Style Modification OT - Medication History OT - Patient Compliance OT - Patient Medical History OT - Predictive Factor OT - Proton Pump Inhibitors COIS- This study was partially supported by a research grant from Hanmi Pharmaceutical Co. Ltd. (research ID: HM-IIT-ESO-004). This was an investigator-initiated study, and the funding company had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication. No other potential conflicts of interest relevant to this article were reported. EDAT- 2023/06/23 06:42 MHDA- 2023/06/23 06:43 PMCR- 2023/08/01 CRDT- 2023/06/23 04:00 PHST- 2023/03/21 00:00 [received] PHST- 2023/06/18 00:00 [accepted] PHST- 2023/06/23 06:43 [medline] PHST- 2023/06/23 06:42 [pubmed] PHST- 2023/06/23 04:00 [entrez] PHST- 2023/08/01 00:00 [pmc-release] AID - ceo.2023.00409 [pii] AID - ceo-2023-00409 [pii] AID - 10.21053/ceo.2023.00409 [doi] PST - ppublish SO - Clin Exp Otorhinolaryngol. 2023 Aug;16(3):259-274. doi: 10.21053/ceo.2023.00409. Epub 2023 Jun 19.