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| |  Further Validation for the PASS Test to Identify Which Patients With GERD May Benefit From Switching Therapy: Presented at DDW By Mary Beth Nierengarten CHICAGO -- June 2, 2009 -- A study presented here at Digestive Disease Week (DDW) 2009 further validates the use of the PASS test to determine which patients with persistent gastro-oesophageal reflux disease (GERD) will benefit from switching therapy to increase acid-suppression therapy. The PASS test is a 5-item questionnaire of Yes/No questions given to patients with persistent acid-related upper gastrointestinal (GI) symptoms to help identify patients who may benefit from changing therapy. The test was initially validated in a small patient group. The current study was undertaken to further validate the PASS test in a larger cohort of patients treated for GERD in primary care centres in 5 geographical areas in Canada. David Armstrong, MD, Division of Gastroenterology, McMaster University, Hamilton, Ontario, presented data from the Cluster-Randomised Study to Examine National Characteristics and Outcome Measures of GERD Patients Utilizing the PPI Acid Suppression Symptom (PASS) Test for Response (EncomPASS) study. The study, presented at DDW on June 1, included 1,564 patients with GERD who failed a PASS test. Patients were randomised to an intervention group (n = 973) or control group (n = 591). Patients in the intervention group received 4 weeks of esomeprazole 20 or 40 mg once daily and those in the control group continued on the non-esomeprazole acid-suppression therapy they were already on for an additional 4 weeks. A change from baseline in the Global Overall Symptom (GOS) score was used to compare the difference in acid-suppression efficacy after 4 weeks. The GOS, a test in which patients self-report the average combined upper GI symptoms, is graded on a 7-point Likert scale. The study found that the patients treated with esomeprazole had significantly greater improvements in the GOS score compared with the control group as demonstrated by a change in baseline scores at 4 weeks (-2.0 vs -1.1; P < .0001). After 4 weeks, the PASS test was again given to the patients and 345 of 973 (35.5%) of patients who received esomeprazole passed the test compared with 78 of 591 (13.2%) of the control patients. In a subgroup analysis done only on patients who had previous PPI therapy (687 in the intervention group and 443 in control), similar results were found with significantly greater improvements in the GOS score in the intervention group compared with the control group (-1.7 vs -0.9; P < .0001). “The findings of this study provide further support for the use of the PASS test to identify primary care patients with persistent gastro-oesophageal reflux disease symptoms that will respond to a change in therapy to increase acid suppression,” said Dr. Armstrong. Digestive Disease Week 2009 is cosponsored by the American Association for the Study of Liver Diseases (AASLD), the American Gastroenterological Association (AGA), the American Society for Gastrointestinal Endoscopy (ASGE), and the Society for Surgery of the Alimentary Tract (SSAT). [Presentation title: Resolution of Persistent GERD Symptoms After a Change in Therapy: EncomPASS - A Cluster-Randomized Study in Primary Care. Abstract M1870]
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