Prospective Single Arm Study on the Effect of Ilaprazole in Patients with Heartburn but No Reflux Esophagitis.
10.3349/ymj.2018.59.8.951
- Author:
In Ji SONG
1
;
Hyun Ki KIM
;
Na Keum LEE
;
Sang Kil LEE
Author Information
1. Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. SKLEE@yuhs.ac
- Publication Type:Original Article
- Keywords:
Heartburn;
reflux esophagitis;
proton pump inhibitors;
ilaprazole
- MeSH:
Arm*;
Biomarkers;
Electric Impedance;
Endoscopy;
Esophagitis;
Esophagitis, Peptic*;
Esophagus;
Gastroesophageal Reflux;
Heartburn*;
Humans;
Hydrogen-Ion Concentration;
Hyperplasia;
Interleukin-8;
Prospective Studies*;
Proton Pump Inhibitors;
T-Lymphocytes
- From:Yonsei Medical Journal
2018;59(8):951-959
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Patients with gastroesophageal reflux disease without esophagitis show varying responses to proton pump inhibitors (PPIs). The aim of this study was to objectively evaluate the effect of a new PPI, ilaprazole, on patients with heartburn but without reflux esophagitis. MATERIALS AND METHODS: This prospective study was performed on 20 patients with heartburn but without reflux esophagitis. All patients underwent upper endoscopy and 24-hr combined multichannel intraluminal impedance and pH esophageal monitoring (MII-pH). They were then treated with ilaprazole (20 mg) once daily for 4 weeks. The GerdQ questionnaire, histologic findings, and inflammatory biomarkers were used for assessment before and after ilaprazole. RESULTS: Among the 20 patients, 13 (65%) showed GerdQ score ≥8. Based on MII-pH results, patients were classified as true nonerosive reflux disease (n=2), hypersensitive esophagus (n=10), and functional heartburn (n=8). After treatment, patients showed a statistically significant improvement in GerdQ score (p < 0.001). Among histopathologic findings, basal cell hyperplasia, papillary elongation, and infiltration of intraepithelial T lymphocytes improved significantly (p=0.008, p=0.021, and p=0.008; respectively). Expression of TNF-α, IL-8, TRPV1, and MCP-1 decreased marginally after treatment (p=0.049, p=0.046, p=0.045, and p=0.042; respectively). CONCLUSION: Daily ilaprazole (20 mg) is efficacious in improving symptom scores, histopathologic findings, and inflammatory biomarkers in patients with heartburn but no reflux esophagitis.
