The Clinical Efficacy of a Pure Alginate Formulation (Lamina G) for Controlling Symptoms in Individuals with Reflux Symptoms: A Randomized Clinical Study
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Background/Aims: Bicarbonate-containing alginate formulations are reported to be effective for controlling reflux symptoms. However, the efficacy of Lamina G alginate without gas production has not been reported. The aim is to evaluate the efficacy of a non-bicarbonate alginate in individuals with reflux symptoms without reflux esophagitis. Methods: Participants who had experienced heartburn or regurgitation for 7 consecutive days were randomized to one of the following treatment groups: proton pump inhibitors (PPI) plus alginate (combination) or PPI plus placebo (PPI only). In addition, as a reference group, patients received placebo plus alginate (alginate only). The primary endpoint compared the percentage of patients with complete resolution of symptoms for the final 7 days of the treatment. Secondary endpoints compared changes in symptom score, symptom-free days during the treatment period, the Reflux Disease Questionnaire, Patient Assessment of Upper Gastrointestinal Disorders (PAGI)-Quality of Life and PAGI-Symptoms Severity Index scores, the investigator’s assessment of symptoms, and incidence of adverse events. Results: Complete resolution of heartburn or regurgitation was not significantly different between the combination and PPI only groups (58.7% vs 57.5%, p=0.903). The secondary endpoints were not significantly different between the two groups. Complete resolution of heartburn or regurgitation, did not differ between the alginate only reference group and the PPI only group (75.0% vs 57.5%, p=0.146). Conclusions: The addition of non-bicarbonate alginate to PPI was no more effective than PPI alone in controlling reflux symptoms.
Abstract
Background/Aims: Bicarbonate-containing alginate formulations are reported to be effective for controlling reflux symptoms. However, the efficacy of Lamina G alginate without gas production has not been reported. The aim is to evaluate the efficacy of a non-bicarbonate alginate in individuals with reflux symptoms without reflux esophagitis. Methods: Participants who had experienced heartburn or regurgitation for 7 consecutive days were randomized to one of the following treatment groups: proton pump inhibitors (PPI) plus alginate (combination) or PPI plus placebo (PPI only). In addition, as a reference group, patients received placebo plus alginate (alginate only). The primary endpoint compared the percentage of patients with complete resolution of symptoms for the final 7 days of the treatment. Secondary endpoints compared changes in symptom score, symptom-free days during the treatment period, the Reflux Disease Questionnaire, Patient Assessment of Upper Gastrointestinal Disorders (PAGI)-Quality of Life and PAGI-Symptoms Severity Index scores, the investigator’s assessment of symptoms, and incidence of adverse events. Results: Complete resolution of heartburn or regurgitation was not significantly different between the combination and PPI only groups (58.7% vs 57.5%, p=0.903). The secondary endpoints were not significantly different between the two groups. Complete resolution of heartburn or regurgitation, did not differ between the alginate only reference group and the PPI only group (75.0% vs 57.5%, p=0.146). Conclusions: The addition of non-bicarbonate alginate to PPI was no more effective than PPI alone in controlling reflux symptoms.
참고문헌 (30)
- Chiu CT, "Randomised clinical trial : sodium alginate oral suspension is non-inferior to omeprazole in the treatment of patients with non-erosive gastroesophageal disease", Aliment Pharmacol Ther, 38, pp.1054~1064 (2013)
- Kahrilas PJ, "The acid pocket : a target for treatment in reflux disease", Am J Gastroenterol, 108, pp.1058~1064 (2013)
- Mandel KG, "Review article : alginate-raft formulations in the treatment of heartburn and acid reflux", Aliment Pharmacol Ther, 14, pp.669~690 (2000)
- Manabe N, "Efficacy of adding sodium alginate to omeprazole in patients with nonerosive reflux disease : a randomized clinical trial", Dis Esophagus, 25, pp.373~380 (2012)
- Reimer C, "Randomised clinical trial: alginate (Gaviscon Advance) vs. placebo as add-on therapy in reflux patients with inadequate response to a once daily proton pump inhibitor", Aliment Pharmacol Ther, 43, pp.899~909 (2016)
- De Ruigh A, "Gaviscon Double Action Liquid(antacid & alginate)is more effective than antacid in controlling post-prandial oesophageal acid exposure in GERD patients : a double-blind crossover study", Aliment Pharmacol Ther, 40, pp.531~537 (2014)
- Dettmar PW, "A comparative study on the raft chemical properties of various alginate antacid raftforming products", Drug Dev Ind Pharm, 44, pp.30~39 (2018)
- Lopes CM, "Overview on gastroretentive drug delivery systems for improving drug bioavailability", Int J Pharm, 510, pp.144~158 (2016)
- Singh BN, "Floating drug delivery systems : an approach to oral controlled drug delivery via gastric retention", J Control Release, 63, pp.235~259 (2000)
- Shaw MJ, "Initial validation of a diagnostic questionnaire for gastroesophageal reflux disease", Am J Gastroenterol, 96, pp.52~57 (2001)
- Cao Y, "Validation of a survey methodology for gastroesophageal reflux disease in China", BMC Gastroenterol, 8, pp.37~ (2008)
- de la Loge C, "Cross-cultural development and validation of a patient self-administered questionnaire to assess quality of life in upper gastrointestinal disorders : the PAGI-QOL", Qual Life Res, 13, pp.1751~1762 (2004)
- Rentz AM, "Development and psychometric evaluation of the Patient Assessment of Upper Gastrointestinal Symptom Severity Index(PAGI-SYM)in patients with upper gastrointestinal disorders", Qual Life Res, 13, pp.1737~1749 (2004)
- Richter JE, "Efficacy and safety of esomeprazole compared with omeprazole in GERD patients with erosive esophagitis : a randomized controlled trial", Am J Gastroenterol, 96, pp.656~665 (2001)
- Bate CM, "Reflux symptom relief with omeprazole in patients without unequivocal oesophagitis", Aliment Pharmacol Ther, 10, pp.547~555 (1996)
- Chiba N, "Speed of healing and symptom relief in grade II to IV gastroesophageal reflux disease : a meta-analysis", Gastroenterology, 112, pp.1798~1810 (1997)
- 정혜경, "위식도역류질환 임상진료지침 개정안 2012", 대한소화기학회지, 60(4), pp.195~218 (2012), 대한소화기학회
- Dean BB, "Effectiveness of proton pump inhibitors in nonerosive reflux disease", Clin Gastroenterol Hepatol, 2, pp.656~664 (2004)
- Richter JE, "Lansoprazole compared with ranitidine for the treatment of nonerosive gastroesophageal reflux disease", Arch Intern Med, 160, pp.1803~1809 (2000)
- Richter JE, "Efficacy of omeprazole for the treatment of symptomatic acid reflux disease without esophagitis", Arch Intern Med, 160, pp.1810~1816 (2000)
- Vaezi MF, "Complications of proton pump inhibitor therapy", Gastroenterology, 153, pp.35~48 (2017)
- Freedberg DE, "The risks and benefits of longterm use of proton pump inhibitors : expert review and best practice advice from the American Gastroenterological Association", Gastroenterology, 152, pp.706~715 (2017)
- Herregods TV, "Pathophysiology of gastroesophageal reflux disease : new understanding in a new era", Neurogastroenterol Motil, 27, pp.1202~1213 (2015)
- Hee Man Kim, "Raft Formation of Sodium Alginate in the Stomach", Journal of Neurogastroenterology and Motility (JNM), 22(4), pp.705~706 (2016), 대한소화기 기능성질환∙운동학회[DOI]
- Woodland P, "Esophageal mucosal integrity in nonerosive reflux disease", J Clin Gastroenterol, 48, pp.6~12 (2014)
- Frazzoni M, "Impedance-pH monitoring for diagnosis of reflux disease : new perspectives", Dig Dis Sci, 62, pp.1881~1889 (2017)
- de Bortoli N, "Association between baseline impedance values and response proton pump inhibitors in patients with heartburn", Clin Gastroenterol Hepatol, 13, pp.1082~1088 (2015)
- Woodland P, "Assessment and protection of esophageal mucosal integrity in patients with heartburn without esophagitis", Am J Gastroenterol, 108, pp.535~543 (2013)
- Woodland P, "Topical protection of human esophageal mucosal integrity", Am J Physiol Gastrointest Liver Physiol, 308, pp.G975~ (2015)[DOI]
- Smart JD, "An in-vitro investigation of mucosa-adhesive materials for use in controlled drug delivery", J Pharm Pharmacol, 36, pp.295~299 (1984)
