Background: Phentermine-topiramate (PT) and naltrexone-bupropion (NB) are widely used combination treatments for obesity and overweight. However, no study has yet compared the efficacy and safety of the two drugs in patients with comorbid psychiatric disorders. Methods: A retrospective chart review of patients who were prescribed with the PT and NB combination treatments was conducted from January 1, 2017, to August 31, 2023. To compare the treatment efficacy, the mean body mass index change rates of both drugs before and after drug use were calculated. The safety of the drug was compared by identifying whether the drug was discontinued early and any side effects that occurred. Results A total of 55 patients were enrolled, most of whom were women (89.1%), and the most commonly diagnosed psychiatric disorder was depressive disorder (37.5% for NB and 40.0% for PT). No demographic differences were observed between the patients using the two drugs. The two drugs showed no statistically significant difference in the treatment efficacy. However, in terms of safety, PT had a lower incidence of adverse effects than NB (6.7% vs.40.0%, p=0.022) Conclusion: No significant difference in the treatment efficacy between PT and NB was observed, but PT showed a more favorable safety profile in psychiatric patients. Further large-scale multicenter studies are needed to confirm these findings.

Background: Phentermine-topiramate (PT) and naltrexone-bupropion (NB) are widely used combination treatments for obesity and overweight. However, no study has yet compared the efficacy and safety of the two drugs in patients with comorbid psychiatric disorders. Methods: A retrospective chart review of patients who were prescribed with the PT and NB combination treatments was conducted from January 1, 2017, to August 31, 2023. To compare the treatment efficacy, the mean body mass index change rates of both drugs before and after drug use were calculated. The safety of the drug was compared by identifying whether the drug was discontinued early and any side effects that occurred. Results A total of 55 patients were enrolled, most of whom were women (89.1%), and the most commonly diagnosed psychiatric disorder was depressive disorder (37.5% for NB and 40.0% for PT). No demographic differences were observed between the patients using the two drugs. The two drugs showed no statistically significant difference in the treatment efficacy. However, in terms of safety, PT had a lower incidence of adverse effects than NB (6.7% vs.40.0%, p=0.022) Conclusion: No significant difference in the treatment efficacy between PT and NB was observed, but PT showed a more favorable safety profile in psychiatric patients. Further large-scale multicenter studies are needed to confirm these findings.

Background: Phentermine-topiramate (PT) and naltrexone-bupropion (NB) are widely used combination treatments for obesity and overweight. However, no study has yet compared the efficacy and safety of the two drugs in patients with comorbid psychiatric disorders. Methods: A retrospective chart review of patients who were prescribed with the PT and NB combination treatments was conducted from January 1, 2017, to August 31, 2023. To compare the treatment efficacy, the mean body mass index change rates of both drugs before and after drug use were calculated. The safety of the drug was compared by identifying whether the drug was discontinued early and any side effects that occurred. Results A total of 55 patients were enrolled, most of whom were women (89.1%), and the most commonly diagnosed psychiatric disorder was depressive disorder (37.5% for NB and 40.0% for PT). No demographic differences were observed between the patients using the two drugs. The two drugs showed no statistically significant difference in the treatment efficacy. However, in terms of safety, PT had a lower incidence of adverse effects than NB (6.7% vs.40.0%, p=0.022) Conclusion: No significant difference in the treatment efficacy between PT and NB was observed, but PT showed a more favorable safety profile in psychiatric patients. Further large-scale multicenter studies are needed to confirm these findings.

Background: Phentermine-topiramate (PT) and naltrexone-bupropion (NB) are widely used combination treatments for obesity and overweight. However, no study has yet compared the efficacy and safety of the two drugs in patients with comorbid psychiatric disorders. Methods: A retrospective chart review of patients who were prescribed with the PT and NB combination treatments was conducted from January 1, 2017, to August 31, 2023. To compare the treatment efficacy, the mean body mass index change rates of both drugs before and after drug use were calculated. The safety of the drug was compared by identifying whether the drug was discontinued early and any side effects that occurred. Results A total of 55 patients were enrolled, most of whom were women (89.1%), and the most commonly diagnosed psychiatric disorder was depressive disorder (37.5% for NB and 40.0% for PT). No demographic differences were observed between the patients using the two drugs. The two drugs showed no statistically significant difference in the treatment efficacy. However, in terms of safety, PT had a lower incidence of adverse effects than NB (6.7% vs.40.0%, p=0.022) Conclusion: No significant difference in the treatment efficacy between PT and NB was observed, but PT showed a more favorable safety profile in psychiatric patients. Further large-scale multicenter studies are needed to confirm these findings.

Background: Phentermine-topiramate (PT) and naltrexone-bupropion (NB) are widely used combination treatments for obesity and overweight. However, no study has yet compared the efficacy and safety of the two drugs in patients with comorbid psychiatric disorders. Methods: A retrospective chart review of patients who were prescribed with the PT and NB combination treatments was conducted from January 1, 2017, to August 31, 2023. To compare the treatment efficacy, the mean body mass index change rates of both drugs before and after drug use were calculated. The safety of the drug was compared by identifying whether the drug was discontinued early and any side effects that occurred. Results A total of 55 patients were enrolled, most of whom were women (89.1%), and the most commonly diagnosed psychiatric disorder was depressive disorder (37.5% for NB and 40.0% for PT). No demographic differences were observed between the patients using the two drugs. The two drugs showed no statistically significant difference in the treatment efficacy. However, in terms of safety, PT had a lower incidence of adverse effects than NB (6.7% vs.40.0%, p=0.022) Conclusion: No significant difference in the treatment efficacy between PT and NB was observed, but PT showed a more favorable safety profile in psychiatric patients. Further large-scale multicenter studies are needed to confirm these findings.

Background/Aims: Gastroesophageal reflux disease (GERD) is a common chronic gastrointestinal disorder that typically requires long-term maintenance therapy. However, little is known about patient preferences and satisfaction and real-world prescription patterns regarding maintenance therapy for GERD. Methods: This observational, cross-sectional, multicenter study involved patients from 18 referral hospitals in Korea. We surveyed patients who had been prescribed proton pump inhibitors (PPIs) for GERD for at least 90 days with a minimum follow-up duration of 1 year. The main outcome was overall patient satisfaction with different maintenance therapy modalities. Results: A total of 197 patients were enrolled. Overall patient satisfaction, patient preferences, and GERD health-related quality of life scores did not significantly differ among the maintenance therapy modality groups. However, the on-demand therapy group experienced a significantly longer disease duration than the continuous therapy group. The continuous therapy group demonstrated a lower level of awareness of potential adverse effects associated with PPIs than the on-demand therapy group but received higher doses of PPIs than the on-demand therapy group. The prescribed doses of PPIs also varied based on the phenotype of GERD, with higher doses prescribed for non-erosive reflux disease than erosive reflux disease. Conclusion Although overall patient satisfaction did not significantly differ among the different PPI maintenance therapy modality groups, awareness of potential adverse effects was significantly different between the on-demand and continuous therapy groups.

Background/Aims: It remains unclear which maintenance treatment modality is most appropriate for mild gastroesophageal reflux disease (GERD).We aimed to compare on-demand treatment with continuous treatment using a proton pump inhibitor (PPI) in the maintenance treatment for patients with non-erosive GERD or mild erosive esophagitis. Methods: Patients whose GERD symptoms improved after 4 weeks of standard dose PPI treatment were prospectively enrolled at 25 hospitals.Subsequently, the enrolled patients were randomly assigned to either an on-demand or a continuous maintenance treatment group, and followed in an 8-week interval for up to 24 weeks. Results: A total of 304 patients were randomized to maintenance treatment (continuous, n = 151 vs on-demand, n = 153). The primary outcome, the overall proportion of unwillingness to continue the assigned maintenance treatment modality, failed to confirm the noninferiority of on-demand treatment (45.9%) compared to continuous treatment (36.1%). Compared with the on-demand group, the GERD symptom and health-related quality of life scores significantly more improved and the overall satisfaction score was significantly higher in the continuous treatment group, particularly at week 8 and week 16 of maintenance treatment. Work impairment scores were not different in the 2 groups, but the prescription cost was less in the on-demand group. Serum gastrin levels significantly elevated in the continuous treatment group, but not in the on-demand group. Conclusions Continuous treatment seems to be more appropriate for the initial maintenance treatment of non-erosive GERD or mild erosive esophagitis than on-demand treatment. Stepping down to on-demand treatment needs to be considered after a sufficient period of continuous treatment.

Gastroesophageal reflux disease (GERD) is a condition in which gastric contents regurgitate into the esophagus or beyond, resulting in either troublesome symptoms or complications. GERD is heterogeneous in terms of varied manifestations, test findings, and treatment responsiveness. GERD diagnosis can be established with symptomatology, pathology, or physiology. Recently the Lyon consensus defined the “proven GERD” with concrete evidence for reflux, including advanced grade erosive esophagitis (Los Angeles classification grades C and or D esophagitis), long-segment Barrett’s mucosa or peptic strictures on endoscopy or distal esophageal acid exposure time > 6% on 24-hour ambulatory pH-impedance monitoring. However, some Asian researchers have different opinions on whether the same standards should be applied to the Asian population. The prevalence of GERD is increasing in Asia. The present evidence-based guidelines were developed using a systematic review and meta-analysis approach. In GERD with typical symptoms, a proton pump inhibitor test can be recommended as a sensitive, cost-effective, and practical test for GERD diagnosis. Based on a meta-analysis of 19 estimated acid-exposure time values in Asians, the reference range upper limit for esophageal acid exposure time was 3.2% (95% confidence interval 2.7-3.9%) in the Asian countries. Esophageal manometry and novel impedance measurements, including mucosal impedance and a post-reflux swallow-induced peristaltic wave, are promising in discrimination of GERD among different reflux phenotypes, thus increasing its diagnostic yield. We also propose a long-term strategy of evidence-based GERD treatment with proton pump inhibitors and other drugs.

Background/Aims: The eradication success rate of Helicobacter pylori (H. pylori) infection with a first-line standard triple therapy (STT) has been decreasing in Korea. However, treatment outcomes of H. pylori infection in Yeongdong, Gangwon Province have been scarcely reported. This study aimed to investigate the treatment outcomes of H. pylori infection in a single tertiary care hospital with regional characteristics. Materials and Methods: From July 2018 to June 2019, a total of 592 patients who underwent STT consisting of a proton pump inhibitor, amoxicillin, and clarithromycin for 7 to 14 days as a first-line H. pylori eradication therapy were included. Demographic data and treatment outcomes were retrospectively reviewed using medical records. Results: The median age of 592 patients was 58 years (range 23 to 86) and 329 patients (55.6%) were men. The indication for eradication therapy included chronic atrophic gastritis (57.9%), peptic ulcer disease (19.6%), and gastric neoplasm after endoscopic resection (5.9%). Most patients (92.2%) received a 7-day course of STT. Eradication rate of STT was 64.0% (379/592). Rescue therapy was performed in 146 patients, and the final eradication rate reached 85.6% (507/592). Conclusions Eradication rate of STT in Yeongdong area of Gangwon Province was unsatisfactory, warranting the consideration of a first-line eradication regimen other than STT.

Purpose: In this trial, we investigated the efficacy and safety of adjuvant letrozole for hormone receptor (HR)-positive breast cancer. Here, we report the clinical outcome in postmenopausal women with HR-positive breast cancer treated with adjuvant letrozole according to estrogen receptor (ER) expression levels. Methods: In this multi-institutional, open-label, observational study, postmenopausal patients with HR-positive breast cancer received adjuvant letrozole (2.5 mg/daily) for 5 years unless they experienced disease progression or unacceptable toxicity or withdrew their consent. The patients were stratified into the following 3 groups according to ER expression levels using a modified Allred score (AS): low, intermediate, and high (AS 3–4, 5–6, and 7–8, respectively). ER expression was centrally reviewed. The primary objective was the 5-year disease-free survival (DFS) rate. Results: Between April 25, 2010, and February 5, 2014, 440 patients were enrolled. With a median follow-up of 62.0 months, the 5-year DFS rate in all patients was 94.2% (95% confidence interval [CI], 91.8–96.6). The 5-year DFS and recurrence-free survival (RFS) rates did not differ according to ER expression; the 5-year DFS rates were 94.3% and 94.1%in the low-to-intermediate and high expression groups, respectively (p = 0.6), and the corresponding 5-year RFS rates were 95.7% and 95.4%, respectively (p = 0.7). Furthermore, 25 patients discontinued letrozole because of drug toxicity. Conclusion Treatment with adjuvant letrozole showed very favorable treatment outcomes and good tolerability among Korean postmenopausal women with ER-positive breast cancer, independent of ER expression.