Laryngology

Weaning of proton pump inhibitors in patients with suspected laryngopharyngeal reflux disease

R. Jun Lin MD

orcid.org/0000-0003-1064-5868

the University of Pittsburgh Voice Center, Division of Laryngology, Department of Otolaryngology, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania

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Shaum Sridharan MD,

Shaum Sridharan MD

Department of Otolaryngology–Head and Neck Surgery, Georgetown University, Washington DC, U.S.A.

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Libby J. Smith DO,

Libby J. Smith DO

the University of Pittsburgh Voice Center, Division of Laryngology, Department of Otolaryngology, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania

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VyVy N. Young MD,

VyVy N. Young MD

orcid.org/0000-0002-3095-8290

the University of Pittsburgh Voice Center, Division of Laryngology, Department of Otolaryngology, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania

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Clark A. Rosen MD,

Corresponding Author

Clark A. Rosen MD

[email protected]

the University of Pittsburgh Voice Center, Division of Laryngology, Department of Otolaryngology, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania

Send correspondence to Clark A. Rosen, MD, UPMC Mercy Hospital University of Pittsburgh Voice Center, Building B, Suite 11500, 1400 Locust Street, Pittsburgh, PA 15219. E-mail: [email protected]Search for more papers by this author

R. Jun Lin MD,

R. Jun Lin MD

orcid.org/0000-0003-1064-5868

the University of Pittsburgh Voice Center, Division of Laryngology, Department of Otolaryngology, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania

Search for more papers by this author

Shaum Sridharan MD,

Shaum Sridharan MD

Department of Otolaryngology–Head and Neck Surgery, Georgetown University, Washington DC, U.S.A.

Search for more papers by this author

Libby J. Smith DO,

Libby J. Smith DO

the University of Pittsburgh Voice Center, Division of Laryngology, Department of Otolaryngology, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania

Search for more papers by this author

VyVy N. Young MD,

VyVy N. Young MD

orcid.org/0000-0002-3095-8290

the University of Pittsburgh Voice Center, Division of Laryngology, Department of Otolaryngology, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania

Search for more papers by this author

Clark A. Rosen MD,

Corresponding Author

Clark A. Rosen MD

[email protected]

the University of Pittsburgh Voice Center, Division of Laryngology, Department of Otolaryngology, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania

First published: 21 July 2017

https://doi.org/10.1002/lary.26696

Citations: 23

Institution where work was performed: the University of Pittsburgh Voice Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, U.S.A.

Presented as a podium presentation at the Triological Society Annual Meeting at Combined Otolaryngology Spring Meetings (COSM), Chicago, Illinois, U.S.A., May 21, 2016.

The authors have no funding, financial relationships, or conflicts of interest to disclose.

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Abstract

Objective

To evaluate the feasibility of a proton pump inhibitor (PPI) weaning protocol in a cohort of patients following successful empiric treatment for suspected laryngopharyngeal reflux disease (LPRD).

Study Design

Retrospective chart review.

Methods

LPRD patients were weaned from PPIs using a standardized weaning protocol. Symptom recurrence rate following PPI wean and present PPI use were determined. All numeric data were analyzed. The setting was a tertiary laryngology practice. The subjects were patients who had a positive response to empiric treatment for LPRD and subsequently were weaned from PPI therapy.

Results

Thirty-five patients with suspected LPRD were instructed to wean from PPI after successful empiric treatment of their LPRD symptoms from July 2013 to September 2015. Twenty-three patients (66%) remained symptom-free post-wean. Twelve patients (34%) had symptom recurrence post-wean; of those, 11 of them (92%) needed to go back on a PPI. Median durations of follow-up for the unsuccessful wean group and the successful wean group were 13 (range 6–29) months and 18 (range 6–38) months, respectively. Pre-wean and post-wean reflux symptom index (RSI) scores in the unsuccessful wean group were 7.7 ± 5.6 and 12.9 ± 6 (P = .11). Pre-wean and post-wean RSI scores in the successful wean group were 8.1 ± 6.5 and 8.1 ± 9.0 (P < .99). Body mass index (BMI) was found to be a significant predictor of failure to wean (odds ratio = 0.72, 95% confidence interval = 0.55–0.95) after controlling for age, sex, PPI treatment duration, and PPI regime. None of the other covariates were found to be significant predictors of failure of PPI wean.

Conclusion

Approximately 66% of patients who were on PPIs for LPRD were successfully weaned. High BMI was significantly predictive of failure to wean.

Level of Evidence

4. Laryngoscope, 128:133–137, 2018

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Volume128, Issue1

January 2018

Pages 133-137

Weaning of proton pump inhibitors in patients with suspected laryngopharyngeal reflux disease

Abstract

Objective

Study Design

Methods

Results

Conclusion

Level of Evidence

BIBLIOGRAPHY

Citing Literature

References

Information

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Weaning of proton pump inhibitors in patients with suspected laryngopharyngeal reflux disease

Abstract

Objective

Study Design

Methods

Results

Conclusion

Level of Evidence

BIBLIOGRAPHY

Citing Literature

References

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