Published online Apr 28, 2015. doi: 10.3748/wjg.v21.i16.5023
Peer-review started: October 21, 2014
First decision: November 14, 2014
Revised: December 9, 2014
Accepted: February 12, 2015
Article in press: February 13, 2015
Published online: April 28, 2015
AIM: To evaluate the efficacy of adding irsogladine maleate (IM) to proton-pump inhibitor (PPI) therapy in non-erosive reflux disease (NERD) treatment.
METHODS: One hundred patients with NERD were recruited and randomized to receive rabeprazole plus IM (group I) or rabeprazole plus placebo (group P). The efficacy of the treatment was assessed using the Frequency Scale for the Symptoms of Gastroesophageal Reflux Disease (FSSG) and the short form (SF)-36 quality of life questionnaires after four weeks of treatment. We also assessed whether patients with NERD with minimal changes (grade M) had different responses to the therapies compared with patients who did not have minimal changes (grade N).
RESULTS: Group I and group P showed significant improvements in their FSSG scores after the treatment (from 17.9 ± 7.9 to 9.0 ± 7.6, and from 17.7 ± 7.3 to 11.2 ± 7.9, respectively, P = 0.0001), but there was no statistically significant difference between the FSSG scores in group I and those in group P. Subgroup analysis showed that significant improvements in the FSSG scores occurred in the patients in group I who had NERD grade N (modified Los Angeles classification) (7.8 ± 7.4 vs 12.5 ± 9.8, P = 0.041). The SF-36 scores for patients with NERD grade N who had received IM and rabeprazole were significantly improved in relation to their vitality and mental health scores.
CONCLUSION: The addition of IM to rabeprazole significantly improves gastroesophageal reflux disease symptoms and the quality of the lives of patients with NERD grade N.
Core tip: Proton pump inhibitor (PPI) therapy is considered the mainstay for the treatment of non-erosive reflux disease (NERD). However, it is less effective in NERD than it is in reflux esophagitis. This study evaluated the efficacy of adding irsogladine maleate (IM) to PPI therapy in the treatment of NERD. Adding IM to rabeprazole improved both the gastroesophageal reflux disease symptoms and the quality of the lives of patients with NERD showing no endoscopic abnormalities, a categorization that was based on the modified Los Angeles classification.