ArticleJournal of gastroenterology2024
Prevalence and risk factors for medication-refractory reflux esophagitis in patients with systemic sclerosis in Japan.
Article in Journal of gastroenterology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed, 2 citations in OpenAlex.
- Proton pump inhibitor use and long-term outcomes in SSc: a real-life analysis from the EUSTAR database.Rheumatology (Oxford, England) · 2026Article
- The Prevalence and Severity of Pain in Patients With Systemic Sclerosis.The Journal of dermatology · 2025Article
- Can personalized optimization of acid suppression dosage and duration improve the management of artificial ulcers after gastric endoscopic submucosal dissection?Journal of gastroenterology · 2025Article
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Authors and funding
14 authors at 1 institution in 1 country.
Funding
Abstract
backgroundsPatients with systemic sclerosis (SSc) often have esophageal motility abnormalities and weak esophago-gastric junction (EGJ) barrier function, which causes proton pump inhibitor (PPI)-refractory reflux esophagitis (RE). The aims of this study were to clarify the current management of RE and prevalence and risk factors of medication-refractory RE in patients with SSc in Japan.
methodsA total of 188 consecutive patients with SSc who underwent both esophageal high-resolution manometry (HRM) and esophagogastroduodenoscopy (EGD) were reviewed. The presence of RE and grades of the gastroesophageal flap valve (GEFV) were assessed. Esophageal motility was assessed retrospectively according to the Chicago classification v3.0. When RE was seen on a standard dose of PPI or any dose of vonoprazan (VPZ), it was defined as medication-refractory RE.
resultsApproximately 80% of patients received maintenance therapy with acid secretion inhibitors regardless of esophageal motility abnormalities. Approximately 50% of patients received maintenance therapy with PPI, and approximately 30% of patients received VPZ. Medication-refractory RE was observed in 30 patients (16.0%). In multivariable analyses, the number of EGD and absent contractility were significant risk factors for medication-refractory RE. Furthermore, combined absent contractility and GEFV grade III or IV had higher odds ratios than did absent contractility alone.
conclusionsPatients with persistent reflux symptoms and those with absent contractility and GEFV grade III or IV should receive maintenance therapy with strong acid inhibition to prevent medication-refractory RE.
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