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The effects of three alternative treatment strategies after 8 weeks of proton pump inhibitor therapy for GERD in children
  1. Ji Hyuk Lee1,
  2. Mi Jin Kim2,
  3. Jong Seung Lee3,
  4. Yon Ho Choe2
  1. 1Department of Pediatrics, College of Medicine, Chungbuk National University, Cheongju, Korea
  2. 2Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
  3. 3Department of Pediatrics, Chung-Ang University Yongsan Hospital, Yongsan, Seoul, Korea
  1. Correspondence to Yon Ho Choe, Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul 135-710, South Korea; i101016{at}skku.edu

Abstract

Objectives The purpose of this 24-week treatment study was to evaluate the effects of three treatment strategies after 8 weeks of lansoprazole therapy for gastroesophageal reflux disease in children.

Design Open-labelled, uncontrolled, prospective study.

Setting Samsung Medical Center, Seoul, Korea.

Methods 37 erosive reflux disease (ERD) and 20 non-erosive reflux disease (NERD) patients were divided into three groups by symptom assessment at 8 weeks: (1) observation without treatment in the ‘symptoms-resolved’ group, (2) ‘on-demand’ treatment for an additional 16 weeks in the ‘symptoms-attenuated’ group and (3) continuous treatment in the ‘symptoms-persistent’ group.

Results For ERD, six (100%) out of six patients in the ‘symptoms-resolved’ group remained improved at weeks 16 and 24. Sixteen (72.7%) out of 22 patients in the ‘symptoms-attenuated’ group had improvement of symptoms at 16 weeks, and 18 (81.8%) patients at 24 weeks. Six (66.7%) out of nine patients in the ‘symptoms-persistent’ group remained improved at weeks 16 and 24. For NERD, seven (100%) out of seven patients in the ‘symptoms-resolved’ group remained improved at weeks 16 and 24. Eight (80.0%) out of 10 patients in the ‘symptoms-attenuated’ group remained improved at week 16, and 10 (100.0%) patients at week 24. None out of three patients in the ‘symptoms-persistent’ group remained improved at weeks 16 and 24.

Conclusions The selection of each alternative for long-term management according to the results of the assessment of symptoms at week 8 was useful and well tolerated. ‘On-demand’ therapy was equally effective. The 16-week therapy had the same efficacy as the 24-week therapy with regard to long-term lansoprazole treatment.

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Footnotes

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Approval for the study was obtained from the Institutional Review Board at Samsung Medical Center.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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