Background: Most patients with gastroesophageal reflux disease experience symptomatic relapse after stopping\nacid-suppressive medication. The aim of this study was to compare willingness to continue treatment with\nesomeprazole on-demand versus continuous maintenance therapy for symptom control in patients with\nnon-erosive reflux disease (NERD) after 6 months.\nMethods: This multicenter, open-label, randomized, parallel-group study enrolled adults with NERD who were\nheartburn-free after 4 weeksââ?¬â?¢ treatment with esomeprazole 20 mg daily. Patients received esomeprazole 20 mg\ndaily continuously or on-demand for 6 months. The primary variable was discontinuation due to unsatisfactory\ntreatment. On-demand treatment was considered non-inferior if the upper limit of the one-sided 95 % confidence\ninterval (CI) for the difference between treatments was <10 %.\nResults: Of 877 patients enrolled, 598 were randomized to maintenance treatment (continuous: n = 297;\non-demand: n = 301). Discontinuation due to unsatisfactory treatment was 6.3 % for on-demand and 9.8 % for\ncontinuous treatment (difference âË?â??3.5 % [90 % CI: âË?â??7.1 %, 0.2 %]). In total, 82.1 and 86.2 % of patients taking\non-demand and continuous therapy, respectively, were satisfied with the treatment of heartburn and regurgitation\nsymptoms, a secondary variable (P = NS). Mean study drug consumption was 0.41 and 0.91 tablets/day, respectively.\nOverall, 5 % of the on-demand group developed reflux esophagitis versus none in the continuous group (P < 0.0001).\nThe Gastrointestinal Symptom Rating Scale Reflux dimension was also improved for continuous versus on-demand\ntreatment. Esomeprazole was well tolerated.\nConclusions: In terms of willingness to continue treatment, on-demand treatment with esomeprazole 20 mg was\nnon-inferior to continuous maintenance treatment and reduced medication usage in patients with NERD who had\nachieved symptom control with initial esomeprazole treatment
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