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위식도 역류 질환에 의한 비심인성 흉통 환자에서 에소메프라졸 20 mg 1일 2회 용법의 치료 효과 평가를 위한 공개, 무작위 배정 예비 연구

Therapeutic Response to 20 mg of Esomeprazole Twice Daily in Patients with Gastroesophageal Reflux Disease-related Non-cardiac Chest Pain: An Open-Label Randomized Pilot Study

대한소화기학회지 2020년 75권 6호 p.333 ~ 340
최재균 ( Choi Jae-Kyun ) - Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Internal Medicine

 ( Shim Hyun-Ik ) - Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Internal Medicine
신철민 ( Shin Cheol-Min ) - Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Internal Medicine
윤혁 ( Yoon Hyuk ) - Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Internal Medicine
박영수 ( Park Young-Soo ) - Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Internal Medicine
김나영 ( Kim Na-young ) - Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Internal Medicine
이동호 ( Lee Dong-Ho ) - Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Internal Medicine

Abstract


Background/Aims: Non-cardiac chest pain (NCCP) is defined as recurrent angina pectoris-like pain without evidence of coronary heart disease, and is usually related to esophageal diseases, such as gastroesophageal reflux disease (GERD). Proton pump inhibitors (PPIs) are important for diagnosis and treatment. Many studies have been conducted on the use of PPIs in patients with GERD-related NCCP. In contrast to standard-dose esomeprazole, the efficacy of half-dose esomeprazole twice daily (BD) has not been established. This study compared the efficacies of the two esomeprazole regimens in GERD-related NCCP.

Methods: In this prospective, open-label study, 37 participants with GERD-related NCCP were randomized to receive either 20 mg of esomeprazole BD (n=21) (esomeprazole BD group) or 40 mg once daily (n=16) (esomeprazole once daily [OD] group) for 4 weeks. In both groups, the chest pain score, which was calculated based on the frequency and severity, was evaluated before and 2 and 4 weeks after administering the medication.

Results: The chest pain score significantly improved in both groups (p<0.001). The proportion of patients with chest pain score improvement >50% was 7.7% higher in the esomeprazole BD group than in the esomeprazole OD group (95.2% vs. 87.5%), but the difference was not significant.

Conclusions: Esomeprazole BD was as effective as esomeprazole OD in improving GERD-related NCCP. Although statistically insignificant, the percentage of patients with >50% reduction in the chest pain score was higher in the esomeprazole BD group than in the esomeprazole OD group. Large-scale studies will be needed to assess these findings further.

키워드

Non-cardiac chest pain; Gastroesophageal reflux; Proton pump inhibitors; Esomeprazole
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