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Obesity Does Not Affect Resolution of Heartburn Symptoms with Esomeprazole: Presented at ACG By Danny Kucharsky PHILADELPHIA, PA -- October 16, 2007 -- Obesity has no apparent effect on baseline heartburn severity or resolution of heartburn symptoms with proton-pump-inhibitor (PPI) therapy in patients with nonerosive reflux disease, according to a study presented at the American College of Gastroenterology (ACG) 2007 Annual Scientific Meeting. These results, discussed here on October 14, suggest that it may not be necessary to adjust the dose of PPIs to these patients based on body mass index (BMI), said investigator Prateek Sharma, MD, Associate Professor of Medicine, Division of Gastroenterology and Hepatology, University of Kansas School of Medicine, Kansas City, Missouri, United States. Previous large-scale epidemiological studies have found an association between obesity and gastroesophageal reflux disease (GERD), and have stated that the risk of developing GERD is double for patients with a BMI of >= 30. This study was a pooled analysis of two similar randomised, double-blind studies aimed at determining whether BMI affects heartburn resolution in patients. The patients were primarily women (62.4%) and had a mean age of 46.4 years. The study attempted to determine whether obese patients -- as far as their symptoms are controlled -- behave any differently in terms of treatment response than non-obese patients, said Dr. Sharma. The retrospective pooled analysis included 704 patients who had nonerosive reflux disease and were randomised to treatment with esomeprazole 20 mg (n = 228), esomeprazole 40 mg (n = 238) or placebo (n = 238). All subjects had experienced frequent heartburn for at least 6 months, and had no evidence of erosive esophagitis confirmed by endoscopy <= 10 days before entering the study. The study found no apparent relationship between baseline heartburn severity and BMI (P =.276). Additionally, baseline heartburn severity did not have a significant effect on heartburn resolution (P =.985; OR = 1.0; 95% CI.97 - 1.03.) Aside from treatment, variables with significant effect on heartburn resolution included age -- with greater odds of heartburn resolution with increased age (P =.004; OR = 1.02; 95% CI 1.01 - 1.03) -- and gender (greater odds of resolution for men than women [P=.028; OR=1.50;95% CI 1.04-2.14]). Dr. Sharma said that, right now, patients should have their doses adjusted based on symptoms, rather than BMI. This study was supported by AstraZeneca Pharmaceuticals. [Presentation title: Effect of Obesity on Symptom Resolution in Patients With Gastroesophageal Reflux Disease (GERD). Abstract 030] E-mail this page to a friend or colleague! To print, use this version