INTRODUCTION In patients with gastroesophageal reflux disease (GERD) on maintenance therapy with acid-suppressive drugs, it is not clear what background factors allow patients to discontinue the drugs. The aims of this study were to examine the relationship of the changes in the frequency and severity of gastrointestinal symptoms after discontinuation of acid-secretion inhibitors for erosive GERD (eGERD) with possible patient background factors and to identify factors that influence these changes. METHODS This is a multicenter, open-label, interventional, exploratory study. eGERD patients with mild mucosal injury whose symptoms were under control and who were on maintenance therapy with acid-suppressive drugs were withdrawn from the drug treatment for 4 weeks. We examined the relationship of patient backgrounds (sex, age, body mass index, alcohol consumption, smoking habits), esophageal hiatal hernia, Helicobacter pylori infection, pepsinogen I and II concentrations and I/II ratios, blood gastrin levels before and after drug discontinuation with total score change in Frequency Scale for the Symptoms of GERD (FSSG). RESULTS Of the 92 patients whose symptoms could be assessed before and after drug withdrawal, 66 patients (71.7% of the total) had FSSG <8 and no symptom relapse after the withdrawal. Furthermore, patient background factors that may be related to symptom relapse/non-relapse were examined, but no related factors were detected. The maintenance medications before discontinuation in the above 92 patients were a proton pump inhibitor (PPI) and vonoprazan (VPZ, a potassium ion competitive acid blocker). Since PPI and VPZ were administered to about the same number of patients, though incidentally, we additionally examined the relationship between patient background factors and symptom relapse/non-relapse by treatment group. As a result, no relevant background factors were detected in both groups. Although there were no significant differences between the two groups, the severity and frequency of symptom recurrence in the VPZ group tended to be higher than in the PPI group. CONCLUSIONS Consideration of background factors is unlikely to be required in the discontinuation of maintenance therapy for eGERD. There was no significant difference in the extent of disease or frequency of recurrence during the discontinuation period, regardless of whether the drug before discontinuation was a PPI or VPZ.

中文翻译：

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轻度糜烂性胃食管反流病患者接受抑酸药物控控维持治疗后停药后症状变化的影响因素检查。

简介 对于接受抑酸药物维持治疗的胃食管反流病 (GERD) 患者，尚不清楚哪些背景因素允许患者停药。本研究的目的是检查糜烂性胃食管反流病（eGERD）停用酸分泌抑制剂后胃肠道症状的频率和严重程度的变化与可能的患者背景因素之间的关系，并确定影响这些变化的因素。方法 这是一项多中心、开放标签、介入性、探索性研究。轻度黏膜损伤的 eGERD 患者，症状得到控制，接受抑酸药物维持治疗，停药 4 周。我们检查了患者背景（性别、年龄、体重指数、饮酒、吸烟习惯）、食管裂孔疝、幽门螺杆菌感染、胃蛋白酶原 I 和 II 浓度及 I/II 比值、停药前后血胃泌素水平的关系GERD 症状频率量表 (FSSG) 的总分变化。结果 92例停药前后可评估症状的患者中，66例（占总数的71.7%）FSSG<8且停药后无症状复发。此外，还检查了可能与症状复发/不复发相关的患者背景因素，但没有检测到相关因素。上述92例患者停药前的维持药物为质子泵抑制剂（PPI）和沃诺拉赞（VPZ，一种钾离子竞争性酸阻滞剂）。由于 PPI 和 VPZ 给药的患者数量大致相同，尽管是偶然，我们还按治疗组检查了患者背景因素与症状复发/不复发之间的关系。结果，两组均未检测到相关背景因素。尽管两组之间没有显着差异，但 VPZ 组症状复发的严重程度和频率往往高于 PPI 组。结论 在停止 eGERD 维持治疗时不太可能需要考虑背景因素。无论停药前使用的药物是 PPI 还是 VPZ，停药期间疾病程度或复发频率均无显着差异。