2020 Seoul Consensus on the Diagnosis and Management of Gastroesophageal Reflux Disease

Jung, Hye‐Kyung; Tae, Chung Hyun; Song, Kyung Ho; Kang, Seung Joo; Park, Jong Kyu; Gong, Eun Jeong; Shin, Jeong Eun; Lim, Hyun Chul; Lee, Sang Kil; Jung, Da Hyun; Choi, Yoon Jin; Seo, Seung In; Kim, Joon Sung; Lee, Jung Min; Kim, Beom Jin; Kang, Sun Hyung; Park, Chan Hyuk; Choi, Suck Chei; Kwon, Joong Goo; Park, Kyung Sik; Park, Moo In; Lee, Tae Hee; Kim, Seung Young; Cho, Young Sin; Lee, Han Hong; Jung, Kee Wook; Kim, Do Hoon; Moon, Hee Seok; Miwa, H.; Chen, Chien‐Lin; Gonlachanvit, Sutep; Ghoshal, Uday C; Wu, Justin C.Y.; Siah, Kewin Tien Ho; Hou, Xiaohua; Oshima, Tadayuki; Choi, Miyoung; Lee, Kwang Jae

doi:10.5056/jnm21077

Cited by 87 publications

(95 citation statements)

References 260 publications

(330 reference statements)

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“…Different symptom manifestations have their own dominant mechanisms. 19 Stress could aggravate heartburn in patients suffering from GERD, and evoke esophageal inflammation. Stress and anxiety also may also intensify the central response to esophageal irritation and inflammation.…”

Section: Discussionmentioning

confidence: 99%

Network Pharmacology Analysis of Hewei Jiangni Granule for Gastroesophageal Reflux Disease and Experimental Verification of Its Anti-Neurogenic Inflammation Mechanism

Cheng¹,

Kou²,

Zhang³

et al. 2022

DDDT

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Purpose Proton pump inhibitors, as the first-line drugs for treating gastroesophageal reflux disease (GERD), are unable to completely relieve patients’ symptoms and patients are prone to recurrence after prolonged drug withdrawal. Thus, it is crucial to find herbal medicines as a complementary and alternative treatment. Hewei Jiangni granule (HWJNG) is a classical Chinese medicinal formula with clinical therapeutic effects on GERD, but its pharmacological mechanism of action remains unclear. This study aimed to explore and then verify the pharmacological mechanisms of HWJNG in GERD therapy. Methods A network pharmacology approach was applied to explore and then verify the pharmacological mechanisms of HWJNG in GERD therapy. The active ingredients of HWJNG, as well as therapeutic targets of GERD were acquired from specialized databases. The “herb-ingredient-gene-target” network for HWJNG in GERD treatment was built. The protein–protein interaction (PPI) network was constructed to screen the core coincident targets. Then, gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were performed. The core targets and signaling pathways associated with the anti-neurogenic inflammatory effect were partially verified via experiments in vivo at molecular level. Results In total, 179 chemical ingredients in HWJNG and 298 intersection targets between GERD and HWJNG were selected from databases. A large proportion of core targets and top signaling pathways were involved in neurogenic inflammation. HWJNG significantly alleviated pathological injuries of esophagus and reversed dilated intracellular spaces. Additionally, HWJNG markedly inhibited the excessive release of inflammatory cytokines such as interleukin (IL)-1β, IL-6, tumor necrosis factor receptor (TNF-a), as well as regulated stimulation sensors including transient receptor potential vanilloid type 1 (TRPV1) and its related neuroinflammatory mediators in GERD mice. Conclusion HWJNG is a promising therapeutic strategy for GERD treatment via regulation of multiple targets and pathways, its effects in alleviating neurogenic inflammation are especially acknowledged.

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Section: Discussionmentioning

confidence: 99%

Network Pharmacology Analysis of Hewei Jiangni Granule for Gastroesophageal Reflux Disease and Experimental Verification of Its Anti-Neurogenic Inflammation Mechanism

Cheng¹,

Kou²,

Zhang³

et al. 2022

DDDT

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“…The reflux burden was relatively low in Asian countries. It was estimated that high‐grade oesophagitis accounts for 1%–13% of oesophagitis 16–18 . Therefore, the proportion of patients with LA classification grade C/D was set at ≥20% in the current study, which was sufficient to cover the prevalence of high‐grade oesophagitis in clinical practice.…”

Section: Methodsmentioning

confidence: 99%

The efficacy and safety of keverprazan, a novel potassium‐competitive acid blocker, in treating erosive oesophagitis: a phase III, randomised, double‐blind multicentre study

Chen

Liu

Chen

et al. 2022

Aliment Pharmacol Ther

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Summary Background Keverprazan is a novel potassium‐competitive acid blocker (P‐CAB) with a strong acid‐suppressive capacity that may provide clinical benefit in acid‐related diseases. Aims This study aimed to explore the non‐inferior efficacy and safety of keverprazan to lansoprazole in treating erosive oesophagitis (EO). Methods This was a phase III, randomised, double‐blind multicentre study. Patients were randomised to receive keverprazan 20 mg once daily or lansoprazole 30 mg once daily for 4–8 weeks. EO healing rates and adverse events (AEs) were compared between the keverprazan group and the lansoprazole group. Results A total of 238 patients comprised the full analysis set (FAS) while 221 patients comprised the per‐protocol set (PPS). For FAS analysis, the EO healing rates at week 8 were 95.8% (114/119) and 89.9% (107/119) for keverprazan and lansoprazole respectively. For PPS analysis, the EO healing rates at week 8 were 99.1% (110/111) and 92.7% (102/110) for keverprazan and lansoprazole respectively. Non‐inferiority of keverprazan compared with lansoprazole according to EO healing rates at 8 weeks was demonstrated in both FAS (difference: 5.8% [95% CI: −0.6% to 12.3%]; p = 0.081) and PPS (difference: 6.1% [95% CI: 1.1%–11.2%]; p = 0.018) analysis. Drug‐related AEs were reported in 34.5% (41/119) patients of the keverprazan group and 25.2% (30/119) patients of the lansoprazole group with no significant difference (p = 0.156). No severe AE happened in the keverprazan group. Conclusions This study demonstrated the non‐inferior efficacy of keverprazan to lansoprazole in treating EO. The incidences of drug‐related AEs were comparable between keverprazan and lansoprazole.

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“…Esophageal carcinomas are one of the most aggressive therapeutically challenging malignant tumors, with a five-year survival rate of less than 15–30%, even for patients who receive curative surgery [ 1 , 2 , 3 ]. In Korea, esophageal cancers stand out as the 8th most common malignancy of cancer-related death, which is a considerably high rank compared with the low incidence of esophageal cancer in Korea [ 3 , 4 ]. These days, special attention is given to an increasing trend of esophageal cancer and gastroesophageal reflux disease (GERD) in Asia, including Korea [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…In Korea, esophageal cancers stand out as the 8th most common malignancy of cancer-related death, which is a considerably high rank compared with the low incidence of esophageal cancer in Korea [ 3 , 4 ]. These days, special attention is given to an increasing trend of esophageal cancer and gastroesophageal reflux disease (GERD) in Asia, including Korea [ 3 , 4 ]. Because of recurrent reflux of stomach contents, GERD might cause esophageal injury, inflammation, activation of proliferative signals, and ultimately DNA damage and malignant transformation.…”

Section: Introductionmentioning

confidence: 99%

“…There might be assumed to be potential links between two diseases. Since the endoscopic surveillance seems not to suppress an increment rate or mortality risk of esophageal cancer [ 4 , 5 ], the identification of modifiable risk factors that would enable us to develop effective prevention strategies is a fundamental priority in reversing the current rising incidence of esophageal carcinoma [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Possible Association between the Use of Proton Pump Inhibitors and H2 Receptor Antagonists, and Esophageal Cancer: A Nested Case–Control Study Using a Korean National Health Screening Cohort

et al. 2022

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Although safety concerns regarding proton pump inhibitor (PPI)/H2-receptor antagonists (H2RA) in the incident esophageal cancer have been raised, the Asian-based report is unclear. We investigated the estimated likelihood of incident esophageal cancer—its mortality depending on prior history of PPI/H2RA use—and gastroesophageal reflux disease (GERD) in Koreans. Using the Korean National Health Insurance Service-Health Screening Cohort data (2002–2015), a case–control study was retrospectively conducted, including 811 patients with incident esophageal cancer and 3244 controls matched with sex, age, income, and residence. Propensity score overlap weighting was adjusted to balance the baseline covariates. Overlap propensity score-weighted logistic regression analyses were assessed to determine associations of the prior exposure of PPI/H2RA (current vs. past) and the medication duration (<30-, 30–90-, vs. ≥90-days) with incident esophageal cancer and its mortality among the total participants or those with/without the GERD episodes, after adjusting for multiple covariates including PPI/H2RA. The current exposure to either PPI or H2RA showed higher odds for incident esophageal cancer than the nonuser group ([13.23; 95%CI 10.25–17.06] and [4.34; 95%CI 3.67–5.14], respectively), especially in all adults over the age of 40 years without GERD. Both current and past exposures to PPI showed a decreased probability of mortality compared with those of the nonuser group ([0.62; 95%CI 0.45–0.86] and [0.41; 95%CI 0.25–0.67], respectively). However, current or past exposure to H2RA harbored the mutually different likelihoods for mortality depending on the presence of GERD and old age. This study carefully speculates on the possible link between PPI/H2RA and incident esophageal cancer in the Korean population. Mortality appears to be affected by certain risk factors depending on drug types, exposure history, old age, and the presence of GERD.

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2020 Seoul Consensus on the Diagnosis and Management of Gastroesophageal Reflux Disease

Cited by 87 publications

References 260 publications

Network Pharmacology Analysis of Hewei Jiangni Granule for Gastroesophageal Reflux Disease and Experimental Verification of Its Anti-Neurogenic Inflammation Mechanism

Network Pharmacology Analysis of Hewei Jiangni Granule for Gastroesophageal Reflux Disease and Experimental Verification of Its Anti-Neurogenic Inflammation Mechanism

The efficacy and safety of keverprazan, a novel potassium‐competitive acid blocker, in treating erosive oesophagitis: a phase III, randomised, double‐blind multicentre study

Possible Association between the Use of Proton Pump Inhibitors and H2 Receptor Antagonists, and Esophageal Cancer: A Nested Case–Control Study Using a Korean National Health Screening Cohort

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