Long‐term treatment of gastro‐oesophageal reflux disease patients with frequent symptomatic relapses using rabeprazole: on‐demand treatment compared with continuous treatment

Abstract

SUMMARYBackground: On-demand treatment may be an alternative in the long-term treatment of non-severe gastrooesophageal reflux disease in patients with frequent symptomatic relapses. Aim: To compare the efficacy of on-demand treatment with rabeprazole 10 mg versus continuous treatment in the long-term treatment of patients with frequent symptomatic relapses of mild to moderate gastrooesophageal reflux disease. Methods: This randomized, open-label study enrolled patients diagnosed with non-erosive reflux disease or oesophagitis grade 1 or 2 (Savary-Miller classification) reporting frequent symptomatic relapses (requiring ‡2 courses of antisecretory therapy during the previous year), whose intensity is rated at least moderate (>2 on a 5-point Likert scale). After a 4-week selection phase with rabeprazole 10 mg once daily, patients reporting symptom relief (Likert score £ 2) were randomized to receive either rabeprazole 10 mg continuous treatment or on-demand treatment for 6 months. The main evaluation criterion was the rate of symptom relief (scored on the Likert scale) after 6 months.

The Effect of Gastroesophageal Flap Valve Appearance on the Management of Patients with Symptoms of Gastroesophageal Reflux Disease

“…Maintenance therapy can be either continuous or intermittent. On-demand therapy, which is a type of intermittent treatment characterized by the patient determining whether or not medication is taken, is thought to be effective in non-erosive reflux disease (NERD) or mild esophagitis [11][12][13]. The presence of hiatus hernia is also an important factor when the response of the patient to treatment and maintenance is taken into consideration [14][15][16].…”

Rabeprazole and esomeprazole in mild-to-moderate erosive gastroesophageal reflux disease: A comparative study of efficacy and safety

“…[25] Rabeprazole was demonstrated to be superior to omeprazole on the first treatment day, by maintaining a higher diurnal and nocturnal gastric pH at half dosage and decreasing more deeply the gastric acidity at full dosage (rabeprazole: 66%, omeprazole: 35%). [26–28]…”

Novel developments in non-erosive and erosive gastroesophageal reflux disease

“…These findings would speak against PPIs as on-demand therapy. Bour et al [32], however, conducted a randomized, open-label study to compare the efficacy of on-demand (n ¼ 71) versus continuous treatment (n ¼ 81) with rabeprazole 10 mg in the long-term treatment of patients with relapsing mild to moderate GERD. After 6 months, the symptom relief rate was higher for patients in the continuous compared with those in the ondemand treatment group (86.4% versus 74.6%, P ¼ 0.065).…”