On-demand therapy for gastroesophageal reflux disease

David C. Metz*, John M. Inadomi, Colin W. Howden, Sander J.Veldhuyzen Van Zanten, Peter Bytzer

*Corresponding author af dette arbejde

    Publikation: Bidrag til tidsskriftReviewForskningpeer review


    The following pages summarize the proceedings of a symposium held in May 2006 on the emerging role of on-demand therapy for gastroesophageal reflux disease (GERD). Medical therapy for GERD has undergone significant change in recent years with the advent of effective, but expensive, antisecretory agents. On-demand (patient-driven) therapy is attractive to payers and patients, because it appears to be both cost-effective and convenient. Many individuals appear to accept occasional symptomatic breakthrough in exchange for personal control of their disease. On-demand therapy should be distinguished from intermittent therapy, which is either patient- or physician-driven, but which requires intermittent episodes of continuous therapy followed by discontinuation until symptoms recur. Proton pump inhibitors appear to be effective on-demand agents despite theoretical pharmacodynamic limitations for this class of drug. The available data support the use of on-demand therapy for GERD in uninvestigated reflux disease, nonerosive reflux disease, and possibly mild esophagitis as well. On-demand therapy should not be considered for patients with severe esophagitis.

    Sider (fra-til)642-653
    Antal sider12
    TidsskriftAmerican Journal of Gastroenterology
    Udgave nummer3
    StatusUdgivet - 1 mar. 2007


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