Although gastroesophageal reflux disease is not as common in Asia as in western countries, the prevalence has increased substantially during the past decade. Gastroesophageal reflux disease is associated with considerable reductions in subjective well-being and work productivity, as well as increased healthcare use. Proton pump inhibitors (PPIs) are currently the most effective treatment for gastroesophageal reflux disease. However, there are limitations associated with these drugs in terms of partial and non-response. Dexlansoprazole is the first PPI with a dual delayed release formulation designed to provide 2 separate releases of medication to extend the duration of effective plasma drug concentration. Dexlansoprazole has been shown to be effective for healing of erosive esophagitis, and to improve subjective well-being by controlling 24-hour symptoms. Dexlansoprazole has also been shown to achieve good plasma concentration regardless of administration with food, providing flexible dosing. Studies in healthy volunteers showed no clinically important effects on exposure to the active metabolite of clopidogrel or clopidogrel-induced platelet inhibition, with no dose adjustment of clopidogrel necessary when coprescribed. This review discusses the role of the new generation PPI, dexlansoprazole, in the treatment of gastroesophageal reflux disease in Asia.
Asia* ; Blood Platelets ; Delayed-Action Preparations ; Delivery of Health Care ; Dexlansoprazole* ; Efficiency ; Esophagitis ; Gastroesophageal Reflux* ; Healthy Volunteers ; Plasma ; Prevalence ; Proton Pump Inhibitors ; Proton Pumps* ; Protons*

Background : Quality of life (QoL) is arguably as important as the survival rate in patients with hepatocellular carcinoma (HCC). However, very few studies have evaluated the factors that determine good or poor QoL in patients with HCC.Objectives:To correlate baseline QoL (EORTC-QLQC30) with baseline laboratory and clinical parameters among HCC patients.Patients and Method: Thirty nine consecutive newly-diagnosed HCC patients were recruited, Spearman;s rank correlation was used to correlate the QoL scores, which consisted of 15 domians, wirg continous baseline variables while the Mann-Whitney U or kruskal Wallis tests were used for categorial variables.Results: The mean age of the cohort was 61.3 +- 14.5, majority of whom were male(89.7). Majority had childs Pugh Turcott (CPT) score af A (61.5%) and barcelona Clinic Liver cancer (BCLC) stage A-B (76.9%). A third (33.3%) knew of their diagnosis at the time of QoL between the 2 groups (p>0.05). There was no consistent pattern in the correlation between laboratory parameters with QoL, with some running contrary to conventional reasoning (Higher international normalized ratio correlation with better role function[p=0.02] and less pain [0.035]; CPT score A associated with lower global health status compared to CPT B/C [p=0.028]). On the other hand, BCLC staging was a more sensible relection of QoL with BCLC A/B patients having higher physical (p=0.014) and social (p=0.049) function, and lower symptom scores for nausses/vomiting (p=0.041) and dyspnea (p=0.004) than patients with BCLC C/D.Conclusion: baseline EORTC-QLC-C30 of patients with HCC has no consistent correlation with the severity of liver dysfunction. Correlation of some domains of the EORTC-QLQ-C30 with BCLC staging suggests that umor burden is the main determinant of QoL in HCC patients. Further studies are needed to determine whether baseline QoL predicts survival independent of HCC staging.
Hepatocellular Carcinoma