Current advances in the treatment of gastroesophageal reflux disease: a focus on esophageal protection


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Abstract

Gastroesophageal reflux disease (GERD) is characterized by high morbidity and a significant decrease in the quality of life of patients, and is a major risk factor for esophageal adenocarcinoma. Nowadays, antisecretory therapy with proton pump inhibitors (PPI) is the "gold standard" of conservative treatment of GERD, but in some cases this therapy is unsuccessful. According to various studies, the prevalence of refractory GERD can reach 30-40%. The latest scientific data in the field of genetics and pathophysiology of GERD demonstrate that a disruption of the barrier function of the esophageal mucosa and an increase of its permeability can be the leading causes of refractoriness. Thus, the optimal therapy for patients with GERD should not only suppress the secretion of hydrochloric acid, but also restore the barrier function of the mucous membrane, providing an esophagoprotective effect. To achieve these goals, Alfasoxx was developed, which consists of a mixture of low molecular weight hyaluronic acid and low molecular weight chondroitin sulfate dissolved in a bioadhesive carrier (poloxamer 407). The clinical efficacy of this product has been confirmed by three prospective, randomized, placebo - controlled trials. Alfasoxx has a healing and restorative effect towards the esophageal epithelium and due to high ability for bioadhesion provides long - term protection of the mucous membrane of the esophagus. Combination therapy for GERD with the use of PPI and an esophagoprotector offers new perspectives for the treatment of patients with GERD.

About the authors

I V Maev

Yevdokimov Moscow State University of Medicine and Dentistry

д.м.н., проф., академик РАН, зав. каф. пропедевтики внутренних болезней и гастроэнтерологии, заслуженный врач РФ, заслуженный деятель науки РФ Moscow, Russia

D N Andreev

Yevdokimov Moscow State University of Medicine and Dentistry

Email: dna-mit8@mail.ru
к.м.н., доц. каф. пропедевтики внутренних болезней и гастроэнтерологии Moscow, Russia

Yu A Kucheryavyy

Yevdokimov Moscow State University of Medicine and Dentistry

к.м.н., доц. каф. пропедевтики внутренних болезней и гастроэнтерологии Moscow, Russia

R I Shaburov

Yevdokimov Moscow State University of Medicine and Dentistry

к.м.н., ассистент каф. пропедевтики внутренних болезней и гастроэнтерологии Moscow, Russia

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