使用诺普拉赞治疗症状轻度反流性食道炎的逐步治疗的有效性
Yorinari Ochiai1, Daisuke Kikuchi1,2, Shu Hoteya1
1Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan.
使用vonoprazan (VPZ) 的逐步降低疗法有效地管理轻度反流性食道炎症状. 这种方法可以根据患者报告的结果减少剂量或停止治疗,从而优化了对GERD的治疗.
科学领域:
- 胃肠病学 胃肠病学
- 药理学 药理学是指药理学的学科.
- 临床医学 临床医学
背景情况:
- 患者报告的结果 (PROs) 对于管理胃食道逆流性疾病 (GERD) 至关重要.
- 日本的GERD指南建议诺普拉赞 (VPZ) 治疗轻度反流性食道炎 (RE).
- 根据症状的缓解,对轻度的RE可能并不总是需要VPZ 20mg的4周疗程.
研究的目的:
- 评估使用vonoprazan (VPZ) 治疗症状轻度反流性食道炎 (RE) 的新型逐步治疗策略的疗效.
- 评估逐渐缩小VPZ疗程对轻度RE患者患者报告结果 (PRO) 的影响.
- 为了确定基于症状的VPZ剂量调整是否有效治疗轻度RE.
主要方法:
- 一项多中心回顾性研究,涉及63名症状轻度RE (洛杉矶分类A或B级) 和FSSG评分≥8.8的患者.
- 逐步降低治疗包括初始28天的VPZ20mg治疗,随后减少到10mg或根据症状改善而停止治疗.
- 剂量调整包括从10mg增加到20mg或在症状恶化时重新开始20mgVPZ.
主要成果:
- 76.2%的患者 (48/63) 经历了FSSG得分降低≥3分的逐步降低治疗.
- 在逐步降低治疗后,FSSG中位数从13显著下降到7 (p < 0.01).
- 71.4% (45/63) 的患者将VPZ剂量从20mg降低到10mg,而46% (29/63) 的患者则停止了VPZ.
结论:
- 使用vonoprazan (VPZ) 的降级疗法为患有症状轻度反流性食道炎 (RE) 的患者提供了可行的治疗选择.
- 这一策略允许根据患者的症状反应进行个性化的治疗调整,从而有可能优化VPZ的使用.
- 基于症状的VPZ逐渐减少在治疗轻度RE方面是有效的,支持其在临床实践中的使用.
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