Mucosal Protective Compounds in the Treatment of Gastroesophageal Reflux Disease. A Position Paper Based on Evidence of the Romanian Society of Neurogastroenterology

Surdea-Blaga, Teodora; Băncilă, Ion; Dobru, Daniela; Drug, Vasile; Frățilă, Ovidiu; Goldiş, Adrian; Grad, Simona; Mureşan, Crina; Nedelcu, Laurențiu; Porr, P. J.; Sporea, Ioan; Dumitraşcu, Dan L.

doi:10.15403/jgld.2014.1121.254.dea

Cited by 27 publications

(15 citation statements)

References 62 publications

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“…to 1 g q.i.d.) and durations of treatment (6, 8, and 12 weeks) showed that sucralfate provided some benefit over placebo in improving symptoms and healing erosive esophagitis, even though statistical significance was not achieved in two of the studies [ 46 ]. A multicenter trial [ 47 ] demonstrated that sucralfate was better than placebo in healing endoscopic lesions, and a recent meta-analysis [ 48 ] also confirmed the superiority of sucralfate over placebo as maintenance therapy of GERD, but it must be emphasized that there are conflicting data regarding the prevention of relapse in erosive esophagitis.…”

Section: Sucralfatementioning

confidence: 99%

Drugs for improving esophageal mucosa defense: where are we now and where are we going?

Savarino

Zentilin

Marabotto

et al. 2017

aog

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In the past, the attention of physiologists and doctors has been mainly focused on the key role of acid in the pathogenesis of gastroesophageal reflux disease (GERD), but increasing evidence that 20-40% of reflux patients respond not at all or only partially to proton pump inhibitors (PPIs) has underlined the concept that factors other than acid are implicated in its development and the elicitation of symptoms. Among these, impaired mucosal integrity, particularly in most patients with non-erosive reflux disease, has recently been reincluded and the reinforcement of defensive mechanisms and/or its protection has been reappointed as a renewed therapeutic target for the management of GERD patients. In this review we will summarize the existing knowledge of the old and novel compounds able to produce this therapeutic effect, including sucralfate, alginate-based drugs, and a new medical device consisting of hyaluronic acid and chondroitin sulfate dispersed in a bioadhesive carrier, together with the potential indications for their use. It is to be stressed, however, that, although these compounds may represent a real alternative to PPI therapy in GERD, the combination of mucosal protection with acid suppression may help manage many cases with a partial or unsatisfactory response to PPIs alone.

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Section: Sucralfatementioning

confidence: 99%

Drugs for improving esophageal mucosa defense: where are we now and where are we going?

Savarino

Zentilin

Marabotto

et al. 2017

aog

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“…The alginate raft then serves as a pH‐neutral barrier over the gastric content and esophageal mucosa. There were clinical studies, reviews, and meta‐analyses indicating that alginates are more effective than placebo or antacids for treating GERD . However, few studies have investigated whether Alginos (TTY Biopharm Co. Ltd.) could be used for treating LPRD.…”

Section: Introductionmentioning

confidence: 99%

Double‐blind, placebo‐controlled study with alginate suspension for laryngopharyngeal reflux disease

Tseng

et al. 2018

The Laryngoscope

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“…166 Although mucosal integrity is impaired in GERD, 146 esophageal mucosal protection has rarely been attempted in the treatment of the disease. 167 Despite in vitro studies showing the efficacy for some drugs (like, for example, sucralfate 168 ), the majority of currently available formulations are ineffective. Indeed, the transit time of liquids through the esophagus is very short (less than 16 s), even in a supine subject.…”

Section: Drugs For Esophageal Mucosal Protectionmentioning

confidence: 99%

Pharmacologic treatment of GERD: Where we are now, and where are we going?

Scarpignato

Hongo

et al. 2020

Annals of the New York Academy of Sciences

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The introduction of acid inhibition in clinical practice has revolutionized the management of acid-related diseases, leading to the virtual abolition of elective surgery for ulcer disease and relegating antireflux surgery to patients with gastroesophageal reflux disease (GERD) not adequately managed by medical therapy. Proton pump inhibitors (PPIs) are the antisecretory drugs of choice for the treatment of reflux disease. However, these drugs still leave some unmet clinical needs in GERD. PPI-refractoriness is common, and persistent symptoms are observed in up to 40-55% of daily PPI users. Potassium-competitive acid blockers (P-CABs) clearly overcome many of the drawbacks and limitations of PPIs, achieving rapid, potent, and prolonged acid suppression, offering the opportunity to address many of the unmet needs. In recent years, it has been increasingly recognized that impaired mucosal integrity is involved in the pathogenesis of GERD. As a consequence, esophageal mucosal protection has emerged as a new, promising therapeutic avenue. When P-CABS are used as add-on medications to standard treatment, a growing body of evidence suggests a significant additional benefit, especially in the relief of symptoms not responding to PPI therapy. On the contrary, reflux inhibitors are considered a promise unfulfilled, and prokinetic agents should only be used on a case-by-case basis.

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Mucosal Protective Compounds in the Treatment of Gastroesophageal Reflux Disease. A Position Paper Based on Evidence of the Romanian Society of Neurogastroenterology

Abstract: Drugs used to protect the esophageal mucosa against acid are useful in alleviating chronic heartburn, especially in patients with mild reflux symptoms.

Cited by 27 publications

References 62 publications

Drugs for improving esophageal mucosa defense: where are we now and where are we going?

Drugs for improving esophageal mucosa defense: where are we now and where are we going?

Double‐blind, placebo‐controlled study with alginate suspension for laryngopharyngeal reflux disease

Pharmacologic treatment of GERD: Where we are now, and where are we going?

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