Twice Daily PPI Induces Higher Remission Rate in Eosinophilic Esophagitis Than Once Daily Regimen Regardless of Total Daily Dose.


Journal

The American journal of gastroenterology
ISSN: 1572-0241
Titre abrégé: Am J Gastroenterol
Pays: United States
ID NLM: 0421030

Informations de publication

Date de publication:
05 Feb 2024
Historique:
received: 31 03 2023
accepted: 29 01 2024
medline: 5 2 2024
pubmed: 5 2 2024
entrez: 5 2 2024
Statut: aheadofprint

Résumé

The optimal proton pump inhibitor (PPI) regimen for eosinophilic esophagitis (EoE) is unclear. We compared histologic response rates of different dosing combinations. 305 newly-diagnosed EoE patients received standard (omeprazole 20mg daily), once-daily moderate (40mg daily), twice-daily moderate (20mg twice daily), or high (40mg twice daily) dose PPI for ≥8 weeks. 42.3% achieved histologic response to PPI, with higher rates for twice-daily (moderate:52.8%/high:54.3%) than once-daily (standard:11.8%/moderate:10%) dosing (p<0.0001). On multivariable analysis, twice-daily moderate (aOR:6.75, CI:2.53-18.0,p=0.0008) and high (aOR:12.8, CI:4.69-34.8,p<0.0001) doses independently predicted histologic response. Twice-daily PPI is associated with higher EoE histologic response rates than once-daily regimen.

Sections du résumé

BACKGROUND BACKGROUND
The optimal proton pump inhibitor (PPI) regimen for eosinophilic esophagitis (EoE) is unclear. We compared histologic response rates of different dosing combinations.
METHODS METHODS
305 newly-diagnosed EoE patients received standard (omeprazole 20mg daily), once-daily moderate (40mg daily), twice-daily moderate (20mg twice daily), or high (40mg twice daily) dose PPI for ≥8 weeks.
RESULTS RESULTS
42.3% achieved histologic response to PPI, with higher rates for twice-daily (moderate:52.8%/high:54.3%) than once-daily (standard:11.8%/moderate:10%) dosing (p<0.0001). On multivariable analysis, twice-daily moderate (aOR:6.75, CI:2.53-18.0,p=0.0008) and high (aOR:12.8, CI:4.69-34.8,p<0.0001) doses independently predicted histologic response.
CONCLUSION CONCLUSIONS
Twice-daily PPI is associated with higher EoE histologic response rates than once-daily regimen.

Identifiants

pubmed: 38314789
doi: 10.14309/ajg.0000000000002712
pii: 00000434-990000000-01016
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 by The American College of Gastroenterology.

Auteurs

Mayssan Muftah (M)

Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Harvard Medical School, Boston, Massachusetts, USA.

Alison H Goldin (AH)

Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Harvard Medical School, Boston, Massachusetts, USA.

Kenneth Barshop (K)

Harvard Medical School, Boston, Massachusetts, USA.
Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.

Karen Hsu Blatman (KH)

Harvard Medical School, Boston, Massachusetts, USA.
Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, Boston, Massachusetts, USA.

Matthew J Hamilton (MJ)

Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Harvard Medical School, Boston, Massachusetts, USA.

Wai-Kit Lo (WK)

Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Harvard Medical School, Boston, Massachusetts, USA.

Jason L Hornick (JL)

Harvard Medical School, Boston, Massachusetts, USA.
Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA.

Walter W Chan (WW)

Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Harvard Medical School, Boston, Massachusetts, USA.

Classifications MeSH