ArticleNeurogastroenterology and motility2018
Abnormal esophageal acid exposure on high-dose proton pump inhibitor therapy is common in systemic sclerosis patients.
Article in Neurogastroenterology and motility, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.
- The role of high-resolution manometry in the assessment of upper gastrointestinal involvement in systemic sclerosis: a systematic review.Clinical rheumatology · 2020Pooled it
- New horizons in systemic sclerosis treatment: advances and emerging therapies in 2025.RMD open · 2025Trial
- Proton pump inhibitor use and long-term outcomes in SSc: a real-life analysis from the EUSTAR database.Rheumatology (Oxford, England) · 2026Article
- Gastrointestinal Disorders in Scleroderma.Gastroenterology · 2026Review
- PPI-Refractory GERD in Systemic Sclerosis Is Driven by Distinct Esophageal and Gastric Motility Abnormalities.medRxiv : the preprint server for health sciences · 2026Article
- The Prevalence and Severity of Pain in Patients With Systemic Sclerosis.The Journal of dermatology · 2025Article
- The impact of gastroesophageal reflux disease and its treatment on interstitial lung disease outcomes.Arthritis research & therapy · 2024Article
- Prevalence and risk factors for medication-refractory reflux esophagitis in patients with systemic sclerosis in Japan.Journal of gastroenterology · 2024Article
- Usefulness of Endoscopy for the Detection and Diagnosis of Primary Esophageal Motility Disorders and Diseases Relating to Abnormal Esophageal Motility.Diagnostics (Basel, Switzerland) · 2023Review
- Proton pump inhibitors in systemic sclerosis: a reappraisal to optimise treatment of gastro-oesophageal reflux disease.The Lancet. Rheumatology · 2022Article
- Gastrointestinal symptom severity and progression in systemic sclerosis.Rheumatology (Oxford, England) · 2022Article
- Use of vonoprazan, a novel potassium-competitive acid blocker, for the treatment of proton pump inhibitor-refractory reflux esophagitis in patients with systemic sclerosis.Journal of scleroderma and related disorders · 2022Article
- Gastrointestinal manifestations of systemic sclerosis: An updated review.World journal of clinical cases · 2021Review
- Esophageal manifestation in patients with scleroderma.World journal of clinical cases · 2021Review
- Gastrointestinal involvement in systemic sclerosis: an update.Current opinion in rheumatology · 2019Review
- GI Manifestations With a Focus on the Esophagus: Recent Progress in Understanding Pathogenesis.Current rheumatology reports · 2019Review
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
backgroundEsophageal dysfunction and gastro-esophageal reflux disease (GERD) are common among patients with systemic sclerosis (SSc). Although high-dose proton pump inhibitors (PPIs) typically normalize esophageal acid exposure, the effectiveness of PPI therapy has not been systematically studied in SSc patients. The aim of this study was to characterize reflux in SSc patients on high-dose PPI using esophageal pH-impedance testing.
methodsIn this case-controlled retrospective analysis, 38 patients fulfilling 2013 American College of Rheumatology SSc criteria who underwent esophageal pH-impedance testing on twice-daily PPI between January 2014 and March 2017 at a tertiary referral center were compared with a control-cohort of 38 non-SSc patients matched for PPI formulation and dose, hiatal hernia size, age, and gender. Patient clinical characteristics, including endoscopy and high-resolution manometry findings, were assessed via chart review. KEY
resultsOn pH-impedance, SSc patients had higher acid exposure times (AETs) than controls. Sixty-one percent of the SSc patients and 18% of the control patients had a total AET ≥4.5% (P < .001). Systemic sclerosis patients also had significantly longer AETs, longer median bolus clearance, and lower nocturnal impedance values. CONCLUSIONS & INFERENCES: Abnormal esophageal acid exposure despite high-dose PPI therapy was common among patients with SSc. The lack of increased reflux episodes in the SSc patients, and longer bolus clearance times and lower nocturnal impedance, supports ineffective clearance as the potential mechanism. Systemic sclerosis patients may require adjunctive therapies to PPIs to control acid reflux.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.