Esophagoprotective therapy in patients with erosive esophagitis
- Authors: Bakulina N.V.1, Tikhonov S.V.1, Topalova Y.G.1, Ilchishina T.A.2, Vasiliev R.V.3
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Affiliations:
- Mechnikov North-Western State Medical University
- SM-Clinic
- Network of Multidisciplinary Clinics “OSNOVA”
- Issue: Vol 94, No 8 (2022)
- Pages: 985-991
- Section: Original articles
- URL: https://journals.rcsi.science/0040-3660/article/view/111824
- DOI: https://doi.org/10.26442/00403660.2022.08.201828
- ID: 111824
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Abstract
Aim. To evaluate the advantages of using combined therapy of proton-pump inhibitors (PPIs) and esophagoprotector in comparison with basic therapy of PPIs for 4 weeks based on the results of changes in the endoscopic picture.To compare the effectiveness of 4-week PPI therapy and 4-week combination therapy with PPI and esophagoprotector Alfasoxx (sodium hyaluronate, chondroitin sulfate, poloxomer 407) in patients with erosive esophagitis (EE) of any degree according to the Los Angeles Endoscopic Classification.
Materials and methods. 81 patients with EE A–C according to the Los Angeles endoscopic classification (1994) was enrolled in the study on the basis of the clinic of Peter the Great, Mechnikov North-Western State Medical University. By computer randomization, patients were divided into the control group – 40 patients (pantoprazole 40 mg 1 time per day) and the intervention group – 41 patients (pantoprazole 40 mg 1 time per day + Alfasoxx 1 sachet qid). The therapy was carried out for 4 weeks. In all patients before and after therapy, the frequency and severity of the main symptoms of gastroesophageal reflux disease (GERD) were assessed, esophagogastroduodenoscopy was performed.
Results. The advantage of combination therapy over standard PPI monotherapy in patients with EE was revealed. According to the results of the control endoscopy, healing of erosions of the esophageal mucosa was observed in 39 out of 41 (95.1%) patients in the intervention group and 32 out of 39 (82.1%) in the control group. The proportion of patients who showed an improvement in the endoscopic picture before and after treatment for 4 weeks by at least 1 level according to the Los Angeles classification was significantly higher in the comparison group – 41 patients (100%), while in the control group 33 patients (85%); p<0.009. After treatment, the combination therapy group had a lower incidence (p<0.01) and severity of heartburn (p<0.01). The same results are demonstrated by combination therapy regarding the symptom – belching of air: in the study group after treatment, this symptom occurred less frequently (p=0.014), its severity was significantly less than in the control group (p<0.01). There was a statistically significant decrease in the need for on-demand antacid therapy in the study group.
Conclusion. In this study involving 81 patients with erosive GERD, the benefits of combination therapy were demonstrated. The addition of Alfasoxx medical device to PPI therapy increases the clinical and endoscopic efficacy of therapy. This positive effect is associated with the esophagoprotective properties of the drug, based on unique pharmacodynamic characteristics. Combination therapy for GERD is preferred in patients with EE. Studies have shown the expediency of using Alfasoxx in case of insufficient effectiveness of classical acid-suppressive therapy for GERD.
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##article.viewOnOriginalSite##About the authors
Natalia V. Bakulina
Mechnikov North-Western State Medical University
Email: topalova.julias@yandex.ru
ORCID iD: 0000-0003-4075-4096
д-р мед. наук, зав. каф. внутренних болезней, клинической фармакологии и нефрологии ФГБОУ ВО «СЗГМУ им. И.И. Мечникова»
Russian Federation, Saint PetersburgSergey V. Tikhonov
Mechnikov North-Western State Medical University
Email: sergeyvt2702@gmail.com
ORCID iD: 0000-0001-5720-3528
MD, Cand. Sci. (Med.), Assistant Professor
Russian Federation, Saint PetersburgYulia G. Topalova
Mechnikov North-Western State Medical University
Email: topalova.julias@yandex.ru
ORCID iD: 0000-0003-3999-6848
SPIN-code: 1301-6443
MD
Russian Federation, Saint PetersburgTatyana A. Ilchishina
SM-Clinic
Email: ita17@mail.ru
ORCID iD: 0000-0002-2327-5248
Cand. Sci. (Med.)
Russian Federation, Saint PetersburgRoman V. Vasiliev
Network of Multidisciplinary Clinics “OSNOVA”
Author for correspondence.
Email: veterenar4ik@mail.ru
ORCID iD: 0000-0001-8289-4420
SPIN-code: 6091-3975
Ph.D. biol. Sci., Associate Professor
Russian Federation, Saint PetersburgReferences
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