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KMID : 1195620230160030259
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Clinical and Experimental Otorhinolaryngology
2023 Volume.16 No. 3 p.259 ~ p.274
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Predictors of Early and Late Response to Esomezol and Lifestyle Modification in Adults With Laryngopharyngeal Reflux Disease: A Prospective, Multicenter, Open-Label Cohort Study
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Kwon Seong-Keun
Park Sung-Joon
Chung Eun-Jae
Sohn Jin-Ho
Sun Dong-Il
Jin Sung-Min
Lee Byung-Joo
Park Il-Seok
Cho Jae-Gu
Park Young-Hak
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Abstract
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Objectives. This study aimed to assess predictors of the response to varying durations of proton pump inhibitor (PPI) useand 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 ofearly and late response to treatment in adult patients (age ≥19 years) with LPRD. Participants underwent standardtreatment (PPI [Esomezol] and lifestyle modification) for 3 months. Response to treatment was defined as greater than50% improvement in reflux symptom index score. The primary outcome was potential predictors of treatment re-sponse 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 re-sponse 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 toachieve a therapeutic response. Future research should explore the incorporation of diverse treatment approaches toimprove treatment outcomes for patients exhibiting negative prognostic indicators.
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KEYWORD
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Laryngopharyngeal Reflux, Proton Pump Inhibitors, Life Style Modification, Predictive Factor, Patient Compliance, Patient Medical History, Medication History
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