Raul E Sanchez, Elizabeth Reichard, Adam Bobbey, Neetu Bali Puri, Peter L Lu, Desale Yacob, Carlo Di Lorenzo, Kent Williams, Karla K H Vaz
{"title":"Delayed Gastric Emptying Correlates With Decreased Post-prandial Motility in Children: A Single-center Retrospective Review.","authors":"Raul E Sanchez, Elizabeth Reichard, Adam Bobbey, Neetu Bali Puri, Peter L Lu, Desale Yacob, Carlo Di Lorenzo, Kent Williams, Karla K H Vaz","doi":"10.5056/jnm24057","DOIUrl":"10.5056/jnm24057","url":null,"abstract":"<p><strong>Background/aims: </strong>Pediatric patients with suspected gastroparesis often undergo antroduodenal manometry (ADM) and gastric emptying scintigraphy (GES) for diagnostic purposes. However, it is unknown if delayed gastric emptying (DGE) correlates with manometric findings. This study evaluates whether ADM parameters differ between normal and abnormal GES in pediatric patients.</p><p><strong>Methods: </strong>Data from pediatric patients undergoing ADM and GES at Nationwide Children's Hospital from 2011-2020 were retrospectively reviewed. Manometry parameters including motility index (Ln [sum of amplitudes × number of contractions + 1]), number of antral contractions, and direction of the phase III migrating motor complex (MMC) were compared to GES results from age-matched patients with DGE (n = 32) and normal gastric emptying (NGE) (n = 32) of similar sex, body mass index, and weight.</p><p><strong>Results: </strong>Children with DGE had a lower post-prandial antral motility index and antral contraction number than those with NGE (9.4 vs 11.2, <i>P</i> = 0.005; 21.8 vs 49.6, <i>P</i> < 0.001). The gastric emptying percentage at 4 hours was lower in patients with retrograde phase III (59.2% vs 83.9%, <i>P</i> = 0.022) and in those without an antral component in the fasting phase III of the migrating motor complex (70.3% vs 86.5%, <i>P</i> = 0.003). Post-prandial antral hypomotility occurred more frequently in the DGE group than in the NGE group (41% vs 9%, <i>P</i> = 0.008).</p><p><strong>Conclusions: </strong>ADM findings differ between children with DGE and NGE. Children with DGE are more likely to have abnormal fasting phase III patterns and decreased post-prandial antral activity during ADM testing.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"31 1","pages":"102-109"},"PeriodicalIF":3.3,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Exploring Diagnostic Challenges at the Intersection of Eating Disorders and Functional Dyspepsia: Implications for Rome V.","authors":"Yong Sung Kim, Sung Hoon Yoon, Suck Chei Choi","doi":"10.5056/jnm24172","DOIUrl":"10.5056/jnm24172","url":null,"abstract":"","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"31 1","pages":"6-7"},"PeriodicalIF":3.3,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tian Li, D Chamil Codipilly, Diana Snyder, Karthik Ravi, Maoyin Pang, Andree H Koop
{"title":"Optimizing Assessment of Contraction Reserve in Ineffective Esophageal Motility: A Study of Upright Multiple Rapid Swallows.","authors":"Tian Li, D Chamil Codipilly, Diana Snyder, Karthik Ravi, Maoyin Pang, Andree H Koop","doi":"10.5056/jnm24097","DOIUrl":"10.5056/jnm24097","url":null,"abstract":"<p><strong>Background/aims: </strong>Multiple rapid swallows (MRS) is a provocative test during high-resolution esophageal manometry (HRM) to evaluate contraction reserve (CR). This study aims to determine the prevalence of CR in patients with ineffective esophageal motility (IEM) and MRS performed in the upright position, and to assess the ideal number of MRS sequences.</p><p><strong>Methods: </strong>We enrolled adult patients diagnosed with IEM according to the Chicago classification version 4.0 who underwent HRM with 3 MRS sequences. Presence of CR was identified as either: the distal contraction integral (DCI) of the post-MRS sequence exceeding the mean DCI of single swallows (ratio > 1) or the mean DCI of the 3 post-MRS sequences surpassing the mean DCI of single swallows. The occurrence of CR was compared following 1, 2, and 3 MRS sequences.</p><p><strong>Results: </strong>When assessing CR in 57 patients referenced to mean single supine swallow DCI, the pooled prevalence of CR following 1, 2, and 3 MRS sequences was 23/57 (40.4%), 31/57 (54.4%), and 33/57 (57.9%), respectively. More patients had CR after 2 MRS sequences compared to 1 (<i>P</i> < 0.001), but there was no significant difference in CR between 2 and 3 MRS sequences (<i>P</i> = 0.160). More patients had CR after 2 (<i>P</i> = 0.013) and 3 MRS sequences (<i>P</i> = 0.034) when CR was referenced to single upright compared to single supine swallows.</p><p><strong>Conclusion: </strong>Among patients with IEM, 58.0% had CR after 3 upright MRS sequences and 2 were adequate to assess CR.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"31 1","pages":"38-44"},"PeriodicalIF":3.3,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Francisco A Félix-Téllez, Alejandra X Cruz-Salgado, José M Remes-Troche, Ángel R Flores-Rendon, Héctor R Ordaz-Álvarez, José A Velarde-Ruiz Velasco, Marco A O Flores-Lizárraga, José I Soto-González, Nadia S Abizaid-Herrera
{"title":"Association Between Functional Dyspepsia and Binge Eating Disorder: A Frequent, Often Overlooked Overlap Clinical Presentation.","authors":"Francisco A Félix-Téllez, Alejandra X Cruz-Salgado, José M Remes-Troche, Ángel R Flores-Rendon, Héctor R Ordaz-Álvarez, José A Velarde-Ruiz Velasco, Marco A O Flores-Lizárraga, José I Soto-González, Nadia S Abizaid-Herrera","doi":"10.5056/jnm24070","DOIUrl":"10.5056/jnm24070","url":null,"abstract":"<p><strong>Background/aims: </strong>This study aims to investigate the association between Binge Eating Disorder and functional dyspepsia in a Mexican population, focusing on symptomatology and demographic characteristics.</p><p><strong>Methods: </strong>We conducted a cross-sectional study on 1016 subjects, evaluating binge eating disorder (BED) and functional dyspepsia based on the Rome IV criteria. Data collection included sociodemographic information, gastrointestinal symptom severity, and anxiety/depression screening using validated tools. A multivariate logistic regression analysis with the χ2 test was conducted for comparison analysis.</p><p><strong>Results: </strong>The prevalence of dyspepsia in BED was 53.6% (95% CI, 46-56). Postprandial fullness (OR, 1.52; 95% CI, 1.06-2.17; <i>P</i> = 0.021) and overlap syndrome (OR, 1.80; 95% CI, 1.25-2.60; <i>P</i> = 0.002) were significantly associated with BED. Patients with BED also presented more severe postprandial distress syndrome (<i>P</i> = 0.027). Anxiety was prevalent in BED patients, while depression was more prominent in patients with BED and dyspepsia overlap.</p><p><strong>Conclusions: </strong>BED patients have a high prevalence of dyspepsia with an association between postprandial fullness and this eating disorder. BED appears to be more prevalent in younger individuals and males. These findings underscore the importance of considering dyspepsia in the management of BED and highlight the need for further research on this association.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"31 1","pages":"95-101"},"PeriodicalIF":3.3,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effect of Anti-reflux Mucosal Ablation on Esophageal Motility in Patients With Gastroesophageal Reflux Disease: A Study Based on High-resolution Impedance Manometry.","authors":"Chien-Chuan Chen, Chu-Kuang Chou, Ming-Ching Yuan, Kun-Feng Tsai, Jia-Feng Wu, Wei-Chi Liao, Han-Mo Chiu, Hsiu-Po Wang, Ming-Shiang Wu, Ping-Huei Tseng","doi":"10.5056/jnm24055","DOIUrl":"10.5056/jnm24055","url":null,"abstract":"<p><strong>Background/aims: </strong>Anti-reflux mucosal ablation (ARMA) is a promising endoscopic intervention for proton pump inhibitor (PPI)-dependent gastroesophageal reflux disease (GERD). However, the effect of ARMA on esophageal motility remains unclear.</p><p><strong>Methods: </strong>Twenty patients with PPI-dependent GERD receiving ARMA were prospectively enrolled. Comprehensive self-report symptom questionnaires, endoscopy, 24-hour impedance-pH monitoring, and high-resolution impedance manometry were performed and analyzed before and 3 months after ARMA.</p><p><strong>Results: </strong>All ARMA procedures were performed successfully. Symptom scores, including GerdQ (11.16 ± 2.67 to 9.11 ± 2.64, <i>P</i> = 0.026) and reflux symptom index (11.63 ± 5.62 to 6.11 ± 3.86, <i>P</i> = 0.001), improved significantly, while 13 patients (65%) reported discontinuation of PPI. Total acid exposure time (5.84 ± 4.63% to 2.83 ± 3.41%, <i>P</i> = 0.024) and number of reflux episodes (73.05 ± 19.34 to 37.55 ± 22.71, <i>P</i> < 0.001) decreased significantly after ARMA. Improved esophagogastric junction (EGJ) barrier function, including increased lower esophageal sphincter resting pressure (13.89 ± 10.78 mmHg to 21.68 ± 11.5 mmHg, <i>P</i> = 0.034), 4-second integrated relaxation pressure (5.75 ± 6.42 mmHg to 9.99 ± 5.89 mmHg, <i>P</i> = 0.020), and EGJ-contractile integral (16.42 ± 16.93 mmHg·cm to 31.95 ± 21.25 mmHg·cm, <i>P</i> = 0.016), were observed. Esophageal body contractility also increased significantly (distal contractile integral, 966.85 ± 845.84 mmHg·s·cm to 1198.8 ± 811.74 mmHg·s·cm, <i>P</i> = 0.023). Patients with symptom improvement had better pre-AMRA esophageal body contractility.</p><p><strong>Conclusions: </strong>ARMA effectively improves symptoms and reflux burden, EGJ barrier function, and esophageal body contractility in patients with PPIdependent GERD during short-term evaluation. Longer follow-up to clarify the sustainability of ARMA is needed.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"31 1","pages":"75-85"},"PeriodicalIF":3.3,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nam Hee Kim, Yoosoo Chang, Seungho Ryu, Chong Il Sohn
{"title":"Impact of Metabolic Health and Its Changes on Erosive Esophagitis Remission: A Cohort Study.","authors":"Nam Hee Kim, Yoosoo Chang, Seungho Ryu, Chong Il Sohn","doi":"10.5056/jnm24058","DOIUrl":"10.5056/jnm24058","url":null,"abstract":"<p><strong>Background/aims: </strong>We aim to compare the remission of erosive esophagitis (EE) among individuals with different phenotypes based on their metabolic health and obesity status and investigate the impact of changes in metabolic health on the EE remission.</p><p><strong>Methods: </strong>Asymptomatic adults (n = 16 845) with EE at baseline, who underwent follow-up esophagogastroduodenoscopy (EGD) were categorized into 4 groups as follows: metabolically healthy (MH) nonobese, metabolically unhealthy (MU) nonobese, MH obese, and MU obese. EE was defined as grade A or higher mucosal breaks observed using esophagogastroduodenoscopy.</p><p><strong>Results: </strong>During a median follow-up of 2.2 years, the remission rates of EE were 286.4/10<sup>3</sup>, 260.1/10<sup>3</sup>, 201.5/10<sup>3</sup>, and 219.9/10<sup>3</sup> person-years in MH nonobese, MU nonobese, MH obese, and MU obese groups, respectively. Multivariate-adjusted hazard ratios (95% CI) for EE remission among the MH nonobese, MU nonobese, and MH obese groups versus that of the MU obese group were 1.30 (1.23-1.37), 1.17 (1.12-1.23), and 0.98 (0.90-1.06), respectively, whereas those of the persistent MH, progression of MH to MU, and remission of MU to MH compared with the persistent MU group were 1.37 (1.23-1.52), 1.15 (1.01-1.30), and 1.28 (1.12-1.46), respectively. Increased EE remission in the persistent MH group was consistently observed in individuals with and without obesity (or abdominal obesity).</p><p><strong>Conclusions: </strong>Metabolic health and nonobesity independently and favorably impact EE remission. Maintaining normal weight and healthy metabolic status may contribute to EE remission.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"31 1","pages":"54-62"},"PeriodicalIF":3.3,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Multiple Rapid Swallows: What Is the Optimal Protocol for Evaluation of Esophageal Contraction Reserve?","authors":"Ping-Huei Tseng","doi":"10.5056/jnm24165","DOIUrl":"10.5056/jnm24165","url":null,"abstract":"","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"31 1","pages":"3-5"},"PeriodicalIF":3.3,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Da Hyun Jung, Young Hoon Youn, Hye-Kyung Jung, Kwang Jae Lee
{"title":"Predictors for the Development of Hypergastrinemia in Maintenance Treatment for Mild Gastroesophageal Reflux Disease Using a Half-dose Proton Pump Inhibitor.","authors":"Da Hyun Jung, Young Hoon Youn, Hye-Kyung Jung, Kwang Jae Lee","doi":"10.5056/jnm24128","DOIUrl":"10.5056/jnm24128","url":null,"abstract":"<p><strong>Background/aims: </strong>Serum gastrin levels may be elevated following proton pump inhibitor (PPI) therapy. We aim to elucidate the predictors for the development of hypergastrinemia in maintenance treatment for mild gastroesophageal reflux disease (GERD) using a half-dose PPI.</p><p><strong>Methods: </strong>This study analyzed data from a prospective randomized trial to compare continuous versus on-demand maintenance treatment modalities in patients with mild GERD. Age, sex, body mass index, <i>Helicobacter pylori</i> infection, serum gastrin levels, pepsinogen (PG) I/II ratios, total days of PPI intake, and weight-based PPI dosage (mg/kg) were evaluated.</p><p><strong>Results: </strong>Data from 293 patients who completed a randomized trial were analyzed (continuous group, n = 147 vs on-demand group, n = 146). In univariate analysis, age (<i>P</i> < 0.001), <i>H. pylori</i> infection (<i>P</i> = 0.012), baseline gastrin levels (<i>P</i> < 0.001), and baseline PG ratios (<i>P</i> = 0.016) significantly correlated with post-treatment gastrin levels. In multivariate analysis, age, baseline gastrin levels, and baseline PG ratios were independently associated with final serum gastrin levels. In univariate analysis, age (<i>P</i> = 0.018), <i>H. pylori</i> infection (<i>P</i> = 0.028), baseline gastrin levels (<i>P</i> = 0.011), and baseline PG ratios (<i>P</i> = 0.031) significantly correlated with the development of hypergastrinemia. In multivariate analysis, age, baseline gastrin levels, and baseline PG ratios were independently associated with the development of hypergastrinemia.</p><p><strong>Conclusion: </strong>Old age, high baseline serum gastrin levels, and low baseline PG ratios are significant predictors of the development of hypergastrinemia in maintenance treatment for mild GERD using a half-dose PPI.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"31 1","pages":"119-128"},"PeriodicalIF":3.3,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Matthew B Stanton, John E Pandolfino, Aditi Simlote, Peter J Kahrilas, Dustin A Carlson
{"title":"The Esophageal Response to Distension on Functional Lumen Imaging Probe Panometry Is Minimally Changed by Conscious Sedation in Healthy Asymptomatic Subjects.","authors":"Matthew B Stanton, John E Pandolfino, Aditi Simlote, Peter J Kahrilas, Dustin A Carlson","doi":"10.5056/jnm24087","DOIUrl":"10.5056/jnm24087","url":null,"abstract":"<p><strong>Background/aims: </strong>Functional lumen imaging probe (FLIP) Panometry has demonstrated utility in the assessment of esophageal motility as a complement to existing methodologies like high-resolution manometry. However, as FLIP is typically performed with sedation during routine endoscopy, there is potential for impact of sedation agents on esophageal motility. We aim to examine the effects of conscious sedation with midazolam and fentanyl on FLIP Panometry metrics and classification.</p><p><strong>Methods: </strong>A cross-over study was conducted on 12 healthy, asymptomatic volunteers that completed FLIP while sedated with intravenous fentanyl and midazolam and while awake on a separate day. FLIP was performed in the same manner in both conditions with transoral placement of the FLIP and stepwise FLIP filling. During awake FLIP, subjects also rated the presence and intensity of esophageal perception.</p><p><strong>Results: </strong>In both experimental conditions, all subjects demonstrated normal motility. The esophagogastric junction distensibility index was lower (median [interquartile range]: 5.8 [5.15-6.85] vs 8.9 [7.68-9.38] mm2/mmHg; <i>P</i> = 0.025), and the FLIP pressure was higher (46.5 [38.125-52.5] vs 33 [26-36.8] mmHg; <i>P</i> = 0.010) in the sedated condition compared to the awake condition. Maximum esophagogastric junction diameter and body distensibility plateau were no different between conditions (<i>P</i> = 0.999 and <i>P</i> = 0.098, respectively). Perception of esophageal sensation during awake FLIP was reported in 7/12 (58%) subjects.</p><p><strong>Conclusions: </strong>While numeric differences in FLIP Panometry metrics were observed between sedated and awake FLIP in healthy subjects, these differences did not change the FLIP Panometry diagnosis. Sedated FLIP offers a well-tolerated method to assess esophageal motility during endoscopy.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"31 1","pages":"45-53"},"PeriodicalIF":3.3,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sang Pyo Lee, In-Kyung Sung, Oh Young Lee, Myung-Gyu Choi, Kyu Chan Huh, Jae-Young Jang, Hoon Jai Chun, Joong-Goo Kwon, Gwang Ha Kim, Nayoung Kim, Poong-Lyul Rhee, Sang Gyun Kim, Hwoon-Yong Jung, Joon Seong Lee, Yong Chan Lee, Hye-Kyung Jung, Jae Gyu Kim, Sung Kook Kim, Chong-Il Sohn
{"title":"Randomized Multicenter Study to Evaluate the Efficacy and Safety of Fexuprazan According to the Timing of Dosing in Patients With Erosive Esophagitis.","authors":"Sang Pyo Lee, In-Kyung Sung, Oh Young Lee, Myung-Gyu Choi, Kyu Chan Huh, Jae-Young Jang, Hoon Jai Chun, Joong-Goo Kwon, Gwang Ha Kim, Nayoung Kim, Poong-Lyul Rhee, Sang Gyun Kim, Hwoon-Yong Jung, Joon Seong Lee, Yong Chan Lee, Hye-Kyung Jung, Jae Gyu Kim, Sung Kook Kim, Chong-Il Sohn","doi":"10.5056/jnm24032","DOIUrl":"10.5056/jnm24032","url":null,"abstract":"<p><strong>Background/aims: </strong>Fexuprazan, a novel potassium-competitive acid blocker, was developed for treating acid-related disorders. Pharmacokinetic and pharmacodynamic properties of fexuprazan, unlike those of proton pump inhibitors, are independent of food effect. This study aims to evaluate differences in efficacy and safety of fexuprazan in patients with erosive esophagitis (EE) according to the timing of dosing.</p><p><strong>Methods: </strong>In this multicenter, open-label noninferiority study, patients who had typical reflux symptoms with endoscopically confirmed EE were randomized 1:1 to receive fexuprazan 40 mg daily 30 minutes before or after meal. Treatment was completed after 2 weeks or 4 weeks when healing was endoscopically confirmed. The primary endpoint was the proportion of patients with healed EE confirmed by endoscopy up to week 4. Safety endpoints included treatment-emergent adverse events (TEAEs).</p><p><strong>Results: </strong>In the prior-to-meal group (n = 89) and after-meal group (n = 86), 4-week EE healing rates were 98.77% and 100.00% (difference, 0.01%; 95% CI, -0.01% to 0.04%) and 2-week EE healing rates were 95.77% and 97.14% (difference, 0.01%; 95% CI, -0.05% to 0.07%), respectively. TEAEs were 9.78% and 8.70% in the prior-to-meal group and the after-meal group, respectively.</p><p><strong>Conclusions: </strong>Non-inferiority analysis revealed that taking fexuprazan after meal was non-inferior to taking fexuprazan before meals in patients with EE. The frequency of adverse events was similar between the 2 study groups. The drug is safe and effective for healing EE regardless of the timing of dosing.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":" ","pages":"86-94"},"PeriodicalIF":3.3,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}