Symptomatic response to lansoprazole predicts abnormal acid reflux in endoscopy-negative patients with non-cardiac chest pain.

Abstract

AIM:

To determine whether symptomatic response to lansoprazole predicts abnormal acid reflux in endoscopy-negative patients with non-cardiac chest pain.

METHODS:

Patients who complained of chest pain, but had normal coronary angiography, were asked to undergo upper endoscopy. Those without gastric and oesophageal lesions were recruited for 24-h ambulatory oesophageal pH monitoring, and were randomly given lansoprazole 30 mg or placebo, both daily for 4 weeks. Chest pain symptoms were recorded before and 1 month after treatment on a locally validated questionnaire. The symptom score was calculated by multiplying the severity and frequency of the symptom, and symptom improvement was defined as > 50% reduction in symptom score.

RESULTS:

Overall, 68 patients, 36 on lansoprazole and 32 on placebo, completed the trial. The symptom score was reduced significantly in both groups (P < 0.001). In the lansoprazole group, more patients with than without abnormal reflux showed symptom improvement (92% vs. 33%; odds ratio = 22; 95% confidence interval, 2.3-201.8; chi2 = 10.9; P = 0.001), giving a sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 92%, 67%, 58%, 94% and 75%, respectively. In the placebo group, the rates of symptom improvement were similar between those with and without abnormal reflux (33% vs. 35%, P = N.S.).

CONCLUSIONS:

Treatment with lansoprazole is a useful test in diagnosing endoscopy-negative gastro-oesophageal reflux disease in Chinese patients with non-cardiac chest pain.

• Authors: H H X Xia, K C Lai, S K Lam, W H C Hu, N Y H Wong, W M Hui, C P Lau, W H Chen, C K Chan, W M Wong, B C Y Wong
• Journal: Alimentary pharmacology & therapeutics (Aliment Pharmacol Ther) Vol. 17 Issue 3 Pg. 369-77 (Feb 2003) ISSN: 0269-2813 [Print] England
• PMID: 12562449 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• 2-Pyridinylmethylsulfinylbenzimidazoles
• Anti-Ulcer Agents
• Lansoprazole
• Omeprazole

Topics

• 2-Pyridinylmethylsulfinylbenzimidazoles
• Adult
• Aged
• Anti-Ulcer Agents (therapeutic use)
• Chest Pain (drug therapy, etiology, physiopathology)
• Female
• Gastroesophageal Reflux (complications, diagnosis, physiopathology)
• Gastroscopy (methods)
• Humans
• Hydrogen-Ion Concentration
• Lansoprazole
• Male
• Middle Aged
• Omeprazole (analogs & derivatives, therapeutic use)
• Predictive Value of Tests
• Prospective Studies