The effect of esomeprazole 20 mg twice daily on acoustic and perception
parameters of the voice in laryngopharyngeal reflux.
Author(s): Fass R, Noelck N, Willis MR, Navarro-Rodriguez T, Wilson K, Powers J,
Barkmeier-Kraemer JM.
Affiliation(s): The Neuroenteric Clinical Research Group, Southern Arizona VA Health Care System
and University of Arizona Health Sciences Center, Tucson, AZ 85723-0001, USA.
ronnie.fass@va.gov
Publication date & source: 2010, Neurogastroenterol Motil. , 22(2):134-41, e44-5
BACKGROUND: Randomized, placebo-controlled studies have failed to demonstrate a
significant treatment effect for laryngopharyngeal reflux (LPR) using traditional
clinical endpoints. We compared the effect of esomeprazole 20 mg twice daily
(b.i.d.) vs placebo on voice and acoustic-related measures in patients with LPR.
METHODS: Patients with LPR underwent endoscopy and pH testing. Subsequently,
patients underwent videostroboscopic recordings of the larynx, acoustic voice and
speech analysis. A voice use and quality diary and oesophageal symptom diary were
completed at baseline. Thereafter, patients were randomized to esomeprazole 20 mg
twice daily vs placebo for 3 months. The voice use and quality diary and
oesophageal symptom dairy were repeated during the last week of treatment.
Videostroboscopy and acoustic voice and speech analysis were also performed at
the end of treatment.
KEY RESULTS: Twenty-four patients were randomized to the esomeprazole group and
17 to the placebo group. There was no significant difference in videostroboscopic
reflux finding scores from baseline to post-treatment. Acoustic measures also
failed to demonstrate significant differences within the same or between groups,
even when a sub-group analysis of patients with endoscopically documented
oesophageal inflammation at baseline was performed. Additionally, no significant
differences were found between groups when using voice use and quality diary.
CONCLUSIONS & INFERENCES: Use of more specific laryngeal functional
parameters such as voice-related acoustic measures of pitch range, fundamental
frequency and intensity also failed to demonstrate a significant response to
proton pump inhibitor treatment as compared to placebo in patients with suspected
LPR.
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