Erosive Esophagitis Needs Fast-Acting New Treatments

Despite targeted treatments for erosive esophagitis (EE), investigators found that management standards of EE were below par, with patients reporting incomplete healing, ongoing symptoms, and relapse. The results of the real-world multicenter study are published in BMJ Open Gastroenterology.

“This real-world multicenter study highlights the need for new, rapidly acting treatments in EE that reduce symptom burden, offer durable healing and provide symptom control,” the authors wrote in the report. “Management of EE remains suboptimal, with many patients experiencing incomplete healing, ongoing symptoms, and relapse despite proton pump inhibitor treatment.”

Through the Study of Acid-Related Disorders, the team of 8 researchers reviewed the data collected from the survey of 102 gastroenterologists (GI) and 149 general practitioners (GP) for a total of 73 patients (mean age at diagnosis, 45.4 years). They found that omeprazole was the preferred first-line treatment drug and pantoprazole were the second preferred treatment.

While 60.8% GIs, and 56.4% GPs preferred omeprazole, 29.4% GIs and 32.9% GPs preferred prantorazole. The reasons for choosing omeprazole were price (55%), insurance coverage (55% HCP), and familiarity (47.9%); whereas the reasons for opting for prantoprazole were insurance coverage (52.0%), price (50.0%), familiarity (48.0%), initial symptom relief (46.0%), and safety (44.0%).

Only 49.3% patients took medication as instructed all the time; but a significant 56.8% of the patients increased their medication frequency on their own volition. The symptoms post-treatment persisted for most of the patients with more than half of the treated patients (57.5%) experiencing heartburn as the most troubling symptom.

The highlight of the study was the need for newer and better treatment options for EE because “only 28.3% HCPs were very satisfied with current treatment options,” the researchers observed. “58.9% patients believed that their symptoms could be better controlled; and 83.6% patients wanted long-lasting treatment options.”

—Priyam Vora

Reference:
Vaezi MF, Brunton S, Mark Fendrick A, et al. Patient journey in erosive oesophagitis: real-world perspectives from US physicians and patients. BMJ Open Gastroenterology. 2022;9:e000941. DOI: 10.1136/bmjgast-2022-000941