Effectiveness of Changing Drug Classes in Patients With Refractory Laryngopharyngeal Reflux Disease.

IF 2.6 3区医学 Q1 OTORHINOLARYNGOLOGY

Otolaryngology- Head and Neck Surgery Pub Date : 2025-02-01 Epub Date: 2024-09-30 DOI:10.1002/ohn.996

Emilie Herman, Sven Saussez, Jérôme R Lechien

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引用次数: 0

Abstract

Objective: To investigate the effectiveness of drug class changes in patients with refractory laryngopharyngeal reflux disease (LPRD).

Study design: Retrospective case series with prospective data.

Setting: Multicenter study.

Methods: The data of patients treated for a refractory LPRD from September 2017 to December 2023 were collected. The effectiveness of drug class changes was assessed through the reflux symptom score (RSS) change. Signs were evaluated with the Reflux Sign Assessment. The RSS reduction was used to categorize the therapeutic responses as mild (20%-40% RSS reduction), moderate (40.1%-60% RSS reduction), high (60.1%-80%), and complete (>80%).

Results: Among the 334 medical records, 74 (22.2%) patients had refractory LPRD defined as no RSS change in the pre- to 3-month posttreatment. The mean age was 52.6 ± 15.5 years. Changing drug class was associated with significant 3- to 6-month posttreatment reductions of RSS and RSA. Thirty patients (39%) did not experience symptom reduction after changing drugs. Changing alginate to magaldrate and magaldrate to alginate was associated with the highest responder rate (76.9%). Changing PPI and alginate/magaldrate molecules led to a response rate of 62.5%. In patients initially treated with a combination of PPI and alginate or magaldrate, changing PPI without changing alginate/magaldrate led to a 37.5% response rate. The baseline RSS was predictive of the 3- and 6-month RSS (therapeutic response).

Conclusion: Changing drug class, especially alginate-to-magaldrate, may be an effective therapeutic approach for patients with a refractory LPRD.

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改变药物类别对难治性喉咽反流病患者的疗效。

研究目的研究设计：具有前瞻性数据的回顾性病例系列：研究设计：具有前瞻性数据的回顾性病例系列：多中心研究：收集2017年9月至2023年12月治疗难治性LPRD患者的数据。通过反流症状评分（RSS）的变化评估药物类别变化的有效性。体征通过反流体征评估进行评估。RSS减少量用于将治疗反应分为轻度（RSS减少20%-40%）、中度（RSS减少40.1%-60%）、高度（60.1%-80%）和完全（>80%）：在 334 份病历中，74 例（22.2%）患者为难治性 LPRD，即治疗前至治疗后 3 个月内 RSS 无变化。平均年龄为（52.6 ± 15.5）岁。更换药物类别与治疗后 3 至 6 个月 RSS 和 RSA 的显著降低有关。30名患者（39%）在更换药物后症状没有减轻。将藻酸盐换为麦角酸盐和将麦角酸盐换为藻酸盐会导致最高的应答率（76.9%）。更换 PPI 和藻酸盐/麦角酸盐分子后，应答率为 62.5%。在最初接受 PPI 和藻酸盐或麦角酸盐联合治疗的患者中，更换 PPI 而不更换藻酸盐/麦角酸盐可使应答率达到 37.5%。基线RSS可预测3个月和6个月的RSS（治疗反应）：结论：对于难治性 LPRD 患者来说，更换药物类别，尤其是将藻酸盐改为镁醛酸盐，可能是一种有效的治疗方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Otolaryngology- Head and Neck Surgery 医学-耳鼻喉科学

CiteScore

6.70

自引率

2.90%

发文量

250

审稿时长

2-4 weeks

期刊介绍： Otolaryngology–Head and Neck Surgery (OTO-HNS) is the official peer-reviewed publication of the American Academy of Otolaryngology–Head and Neck Surgery Foundation. The mission of Otolaryngology–Head and Neck Surgery is to publish contemporary, ethical, clinically relevant information in otolaryngology, head and neck surgery (ear, nose, throat, head, and neck disorders) that can be used by otolaryngologists, clinicians, scientists, and specialists to improve patient care and public health.