دورية أكاديمية
Randomised clinical trial: the use of alginates during preinvestigation proton pump inhibitor wash-out and their impact on compliance and symptom burden
العنوان: | Randomised clinical trial: the use of alginates during preinvestigation proton pump inhibitor wash-out and their impact on compliance and symptom burden |
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المؤلفون: | Andres Vales, Anthony Hobson, Philip Woodland, Kate Plehhova, Cathal Coyle |
المصدر: | BMJ Open Gastroenterology, Vol 10, Iss 1 (2023) |
بيانات النشر: | BMJ Publishing Group, 2023. |
سنة النشر: | 2023 |
المجموعة: | LCC:Diseases of the digestive system. Gastroenterology |
مصطلحات موضوعية: | Diseases of the digestive system. Gastroenterology, RC799-869 |
الوصف: | Background/aims Investigation of gastro-oesophageal reflux disease is usually performed off proton pump inhibitors (PPIs). This can exacerbate symptoms, potentially impacting investigation accuracy if patients circumvent the preinvestigation instructions. There are no standard recommendations on how to manage PPI withdrawal. We aimed to assess the impact of structured alginate use on symptom burden.Methods Participants were already established on ≥4 weeks of PPI therapy and being referred for manometry and 24-hour pH/impedance testing. Preinvestigation instructions involved stopping PPIs and H2 receptor antagonists for 1 week, but antacids and alginates were allowed until the night before. Participants were randomised to follow these standard instructions (control group), or the same instructions with the provision of Gaviscon Advance to be taken four times daily (treatment group). The primary outcome assessed change in Gastro-Oesophageal Reflux Disease Health-Related Quality of Life Score.Key results Data for 48 patients were available for primary outcome assessment. While patients in the control group had a significant increase in symptoms (median difference 6.5, 95% CI (1 to 7), p=0.04), no change occurred in the treatment arm (median difference -1.5, 95% CI (-2, 3.5), p=0.54). There were no serious adverse events.Conclusions Structured alginate use prevents symptom exacerbation during preinvestigation PPI wash-out. These findings are limited to the 1-week wash-out period but can benefit thousands of patients undergoing investigation for gastro-oesophageal reflux each year. Further research is required to assess this effect in other settings, such as sustained PPI deprescription. The trial was funded by Reckitt Benckiser.Trial registration number EudraCT registration 2019-004561-41 |
نوع الوثيقة: | article |
وصف الملف: | electronic resource |
اللغة: | English |
تدمد: | 2054-4774 |
Relation: | https://bmjopengastro.bmj.com/content/10/1/e001026.full; https://doaj.org/toc/2054-4774 |
DOI: | 10.1136/bmjgast-2022-001026 |
URL الوصول: | https://doaj.org/article/258680f6fd234607b9ff76ebc888065d |
رقم الأكسشن: | edsdoj.258680f6fd234607b9ff76ebc888065d |
قاعدة البيانات: | Directory of Open Access Journals |
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