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随机临床试验:埃索美拉唑治疗前后未明确诊断的消化不良的疾病负担——来自 STARS II 研究的结果。

Randomised clinical trial: the burden of illness of uninvestigated dyspepsia before and after treatment with esomeprazole--results from the STARS II study.

机构信息

Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.

出版信息

Aliment Pharmacol Ther. 2011 Oct;34(7):714-23. doi: 10.1111/j.1365-2036.2011.04789.x. Epub 2011 Aug 17.

Abstract

BACKGROUND

Patients with dyspepsia often experience troublesome symptoms.

AIM

To assess the burden of uninvestigated dyspepsia (symptoms, health-related quality of life [HRQL] and work productivity) before and after 8 weeks' esomeprazole treatment.

METHODS

Patients (n=1250) with uninvestigated dyspepsia (no endoscopy within 6 months and ≤ 2 endoscopies within 10 years) underwent a 1-week esomeprazole acid-suppression test before randomisation to 7 weeks' esomeprazole or placebo. The Reflux Disease Questionnaire (RDQ), Quality of Life in Reflux and Dyspepsia (QOLRAD) and Work Productivity and Activity Impairment (WPAI) questionnaires were completed at baseline (1-week off-treatment) and 8 weeks. WPAI results were further analysed among patients who responded to the acid-suppression test.

RESULTS

The highest baseline symptom score was for the RDQ dyspepsia domain, and the highest disease burden was for QOLRAD vitality and food/drink problems. After 8 weeks, significant improvements vs. placebo were observed for all RDQ and QOLRAD domains. The sub-population of acid-suppression test responders, but not the total WPAI population, had a significant work productivity improvement vs. placebo.

CONCLUSIONS

Uninvestigated dyspepsia is associated with high symptom load and impacts on HRQL and work productivity. Esomeprazole improves HRQL among such patients, and improves work productivity among 1-week acid-suppression trial responders. ClinicalTrials.gov identifier: NCT00251992.

摘要

背景

消化不良患者常经历令人困扰的症状。

目的

评估未经调查的消化不良(症状、健康相关生活质量[HRQL]和工作生产力)在埃索美拉唑治疗 8 周前后的负担。

方法

未经调查的消化不良患者(6 个月内无内镜检查,10 年内内镜检查次数≤2 次)进行了 1 周埃索美拉唑抑酸试验,然后随机分配接受 7 周埃索美拉唑或安慰剂治疗。在基线(停药 1 周)和 8 周时完成反流疾病问卷(RDQ)、反流和消化不良生活质量(QOLRAD)和工作生产力和活动障碍(WPAI)问卷。WPAI 结果进一步在对抑酸试验有反应的患者中进行分析。

结果

RDQ 消化不良域的基线症状评分最高,QOLRAD 活力和饮食/饮水问题的疾病负担最高。与安慰剂相比,治疗 8 周后,所有 RDQ 和 QOLRAD 域均有显著改善。抑酸试验反应者亚组(而非总 WPAI 人群)与安慰剂相比,工作生产力有显著改善。

结论

未经调查的消化不良与高症状负担相关,对 HRQL 和工作生产力有影响。埃索美拉唑可改善此类患者的 HRQL,并改善 1 周抑酸试验反应者的工作生产力。临床试验注册号:NCT00251992。

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