Objective.A pooled analysis,using data from three prospective,randomized,double-blind,placebo-controlled,clinical studies,was undertaken to determine the relationship between well-being and subsequent clinical respons...Objective.A pooled analysis,using data from three prospective,randomized,double-blind,placebo-controlled,clinical studies,was undertaken to determine the relationship between well-being and subsequent clinical response to acid suppressant therapy in 1887 adult patients with reflux symptoms(with/without endoscopically verified erosive esophagitis).Material and methods.Well-being was assessed at study entry using the Psychological General Well-Being(PGWB)Index.Patients were assessed for complete relief of heartburn(absence of symptoms in the preceding 7 days)after 4 weeks’treatment(omeprazole 10 or 20 mg once daily;ranitidine 150 mg twice daily).Results.Multiple logistic regression analysis identified baseline PGWB Index total score and anxiety score as independent prognostic indicators of treatment response in endoscopy-positive patients(n = 1333).Thus,the likelihood of achieving complete heartburn relief was impaired by high baseline levels of anxiety or a low total well-being score.In the endoscopy-negative group,high levels of depression and low vitality scores affected treatment response adversely.Furthermore,age(for endoscopy-positive patients only)and body mass index(for endoscopy-negative patients only)showed an association with treatment outcome.Gender seemed to have no prognostic value on treatment outcome.Conclusions.Patient well-being may be a useful prognostic indicator in patients presenting with reflux symptoms,with a high level of anxiety predicating against a response to acid suppressant therapy,particularly in those with normal endoscopic findings.展开更多
文摘Objective.A pooled analysis,using data from three prospective,randomized,double-blind,placebo-controlled,clinical studies,was undertaken to determine the relationship between well-being and subsequent clinical response to acid suppressant therapy in 1887 adult patients with reflux symptoms(with/without endoscopically verified erosive esophagitis).Material and methods.Well-being was assessed at study entry using the Psychological General Well-Being(PGWB)Index.Patients were assessed for complete relief of heartburn(absence of symptoms in the preceding 7 days)after 4 weeks’treatment(omeprazole 10 or 20 mg once daily;ranitidine 150 mg twice daily).Results.Multiple logistic regression analysis identified baseline PGWB Index total score and anxiety score as independent prognostic indicators of treatment response in endoscopy-positive patients(n = 1333).Thus,the likelihood of achieving complete heartburn relief was impaired by high baseline levels of anxiety or a low total well-being score.In the endoscopy-negative group,high levels of depression and low vitality scores affected treatment response adversely.Furthermore,age(for endoscopy-positive patients only)and body mass index(for endoscopy-negative patients only)showed an association with treatment outcome.Gender seemed to have no prognostic value on treatment outcome.Conclusions.Patient well-being may be a useful prognostic indicator in patients presenting with reflux symptoms,with a high level of anxiety predicating against a response to acid suppressant therapy,particularly in those with normal endoscopic findings.
