PROGNOSTIC FACTORS FOR RELAPSE AND MAINTENANCE TREATMENT WITH CISAPRIDE IN GASTROESOPHAGEAL REFLUX DISEASE

Aim: To perform a further Cox proportional hazards logistic regression analysis of data from two large-scale placebo-controlled trials with cisapride as maintenance treatment in reflux disease. Results: Analysi s of each of the two databases, allowing the model to operate freely, led to the identification of a number of unexpected putative predictor s of outcome in the 6 to 12 months following initial healing of oesoph agitis with an H-2-receptor antagonist or omeprazole. This allowed us to delineate more accurately the patient population that is likely to respond to long-term continuous treatment with low or standard dose ci sapride. The analysis revealed that symptom severity may be more usefu l than endoscopic severity in predicting relapse or in guiding therapy , Reflux oesophagitis outcome is particularly poor in the presence of treatment-recalcitrant symptoms or severe mucosal damage. Analysis sho wed cisapride to be effective in the maintenance treatment of patients with non-refractory symptoms, irrespective of the initial severity of oesophagitis, the healing agent used, or a history of previous endosc opic relapses.