Sang Young Seol

Eradication Rates of Helicobacter pylori in Korea Over the Past 10 years and Correlation of the Amount of Antibiotics Use: Nationwide Survey.

The efficacy of proton‐pump inhibitor–amoxicillin–clarithromycin therapy for H. pylori eradication has decreased over time.

Current status of endoscopic submucosal dissection for the management of early gastric cancer: A Korean perspective

The early diagnosis of gastric cancer allows patients and physicians to pursue the option of endoscopic resection, which is significantly less invasive than conventional surgical resection. In Korea, the use of endoscopic submucosal dissection (ESD) has been increasing, and many reports on ESD have been published. In addition, Korean gastroenterologists from several hospitals performing ESD have conducted formal meetings to discuss useful information regarding ESD. Here, we discuss the Korean experience with ESD, including outcomes and prospects of endoscopic treatments.

Randomized, Controlled, Multi-center Trial: Comparing the Safety and Efficacy of DA-9701 and Itopride Hydrochloride in Patients With Functional Dyspepsia.

Background/Aims Therapies of functional dyspepsia (FD) are limited. DA-9701 is a novel prokinetic agent formulated with Pharbitis semen and Corydalis Tuber. We aimed to assess the efficacy of DA-9701 compared with itopride in FD patients. Methods Patients with FD randomly received either itopride 50 mg or DA-9701 30 mg t.i.d after a 2-week baseline period. After 4 weeks of treatment, 2 primary efficacy endpoints were analyzed: the change from baseline in composite score of the 8 dyspeptic symptoms and the overall treatment effect. Impact on patients’ quality of life was assessed using the Nepean Dyspepsia Index (NDI) questionnaire. Results We randomly assigned 464 patients with 455 having outcome data. The difference of the composite score change of the 8 symptoms between the 2 groups was 0.62, indicating that DA-9701 was not inferior to itopride. The overall treatment effect response rate was not different between the groups. When responder was defined as ≥ 5 of the 7 Likert scale, responder rates were 37% of DA-9701 and 36% of itopride group. Patients receiving DA-9701 experienced similar mean percentage of days with adequate relief during the 4-week treatment period compared with those receiving itopride (56.8% vs 59.1%). Both drugs increased the NDI score of 5 domains without any difference in change of the NDI score between the groups. The safety profile of both drugs was comparable. Conclusions DA-9701 significantly improves symptoms in patients with FD. DA-9701 showed non-inferior efficacy to itopride with comparable safety.

Failure of a Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Efficacy of H. pylori Eradication in H. pylori-Infected Patients with Functional Dyspepsia

Background/Aims The role of Helicobacter pylori eradication in patients with functional dyspepsia (FD) is still uncertain. We originally planned a randomized clinical study to observe dyspeptic symptoms after H. pylori eradication therapy. However, we failed to complete the study; therefore, we analyzed the factors that affected the failure of the study. Methods Interviews and questionnaire surveys were conducted to analyze the factors that induced early termination from the study. Results Many patients were screened by gastroenterologists at 11 tertiary referral hospitals between July 2009 and August 2010; however, only 4 patients met the enrollment criteria. Most patients who visited our clinics had been experiencing FD symptoms for less than 6 months or were already taking medication. They also demanded to continue taking medications and using other drugs. Only 3 of the 4 patients signed informed consent. Conclusions The application of the current Rome III criteria to FD is difficult to evaluate in Korean patients with dyspeptic symptoms because of the early medical evaluation. Most Korean patients who were diagnosed with FD by the Rome III criteria did not overcome their fear of being unable to use rescue medications during the study period.

Tu1119 A Randomized, Double Blinded, Multicenter Clinical Trial to Assess the Efficacy and Safety of Lafutidine in the Management of Reflux Esophagitis

Background. The use of patient reported outcome (PRO)measures for evaluation of functional diseases is frequent and is based on the concept that healthcare personnel cannot appropriately evaluate patients perception of symptom severity. Previously, we described that output scores from both, patient (using ReQuest in PracticeTM questionnaire) and physician (Likert scale), had enough sensitivity to detect changes on GERD symptoms severity.1 The aim of this analysis was to evaluate the effect of exogenous latent factors, like patient characteristics (BMI, age), physician evaluation (clinical specialty, Likert symptoms score) and PROmeasures (ReQuest in PracticeTM on basal evaluation) over endogen factors (ReQuest in PracticeTM results 2nd and 4thweek of treatment) in a cohort of patients withGERD receivingMagnesium pantoprazole (Mg-Pa). Material and Methods. A total of 3665 patients with clinical diagnostic of GERD were enrolled by 1306 practitioners in a nationwide, prospective, observational study. They were treated with Mg-Pa 40mg for 28 days. To evaluate the severity of GERD symptoms, patients answered ReQuest-in-PracticeTM, a PRO instrument, every week. Physicians also assessed symptom severity with a 4-point Likert scale. Lineal combination and data transformation to Z-scores (structural equation model) was performed to assess the effect size of each factor over symptom severity progression. Endogenous variables were ReQuest in PracticeTM results at 2nd and 4th weeks. Results. A total of 2345 patients were included in the analysis (mean age 36 ± 8 years old, 54% females). Patient characteristics did not show influence upon ReQuest in PracticeTM results (2nd week of treatment, b= 0.05; 4th week, b=0.03; p-value > 0.1 for both). ReQuest in PracticeTM questionnaire showed median influence (week 2, b= 0.34; week 4, b= 0.12; p<0.05). In contrast, physician effect was of relevance (2nd week b= 0.89; 4th week b=0.78; p<0.05). Conclusion. Physicians can have a valid subjective impression about the symptoms severity percibed by the patient. The evaluation of a clinical response to GERD treatment can be supported by clinicians appreciation and not only by PRO instruments. 1.Lopez-Alvarenga et al. J Neurogastroenterol Motil 2011;17:381-6

Tu1067 Efficacy of S-Pantoprazole 20 mg Compared With Pantoprazole 40 mg in the Treatment of Reflux Esophagitis: A Randomized, Double-Blind Comparative Trial

Background S-isomer (S) pantoprazole is known to be more effective and less dependent on cytochrome 2C19 than R-isomer (R)-pantoprazole.