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Publication year
2009Source
Alimentary Pharmacology & Therapeutics, 30, 1, (2009), pp. 82-9ISSN
Publication type
Article / Letter to editor
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Organization
Gastroenterology
Human Genetics
Pathology
Journal title
Alimentary Pharmacology & Therapeutics
Volume
vol. 30
Issue
iss. 1
Page start
p. 82
Page end
p. 9
Subject
IGMD 2: Molecular gastro-enterology and hepatology; IGMD 3: Genomic disorders and inherited multi-system disorders; NCEBP 1: Molecular epidemiologyAbstract
BACKGROUND: The most effective initial treatment strategy of dyspepsia is still under debate. Individual biological characteristics, such as condition of gastric mucosa, might contribute to selection of the most appropriate acid suppression treatment strategy. AIM: To assess whether pre-treatment testing of gastric mucosal status is relevant for treatment success in an RCT comparing step-up and step-down therapies in newly diagnosed dyspepsia patients. METHODS: Baseline serum samples were collected to assess gastric mucosal status using serum levels of pepsinogens-I&II, gastrin-17, and Helicobacter pylori IgA/IgG-antibodies. The 6-month treatment success was compared between step-up and step-down for patients with serum diagnoses: normal; gastritis; corpus atrophy or antrum atrophy. RESULTS: In all, 519 patients (M/F: 249/270, age: 47 (18-85) years, 29%H. pylori+) were randomized to step-up (n = 293) or step-down (n = 226). Normal mucosa, gastritis and corpus atrophy were diagnosed serologically in 70%, 28% and 2% of the patients, evenly distributed between the strategies (P = 0.65). Treatment success was achieved in respectively, 69%, 70% and 70% for the serum diagnosis groups, and did not differ between the strategies. CONCLUSIONS: Dyspepsia treatment success could not be predicted by gastric mucosal status. Therefore, serum diagnosis of gastric mucosal status is no useful tool for patient allocation to acid suppressive treatment strategies.
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- Faculty of Medical Sciences [92874]
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