Proton pump inhibitor use and treatment satisfaction in Spanish patients with systemic sclerosis: Insights from a nationwide survey.

OBJECTIVE

To evaluate real-world patterns of proton pump inhibitor use, treatment compliance, and patient-perceived effectiveness in the control of gastroesophageal reflux symptoms and their impact on quality of life in patients with systemic sclerosis.

PATIENTS AND

METHODS

We conducted a cross-sectional, patient-reported survey distributed through the Asociación Española de Esclerodermia. Participants provided sociodemographic and clinical data and completed items addressing reflux symptoms and their impact on quality of life, dosing schedule, compliance, and perceived effectiveness in controlling esophageal and extra-esophageal symptoms.

RESULTS

A total of 141 patients responded (83% female; mean age 56±10 years; diffuse-subset=56, limited-subset=52). One hundred thirty (92%) reported reflux symptoms, with 54 (42%) developing reflux symptoms before being diagnosed with systemic sclerosis. Current chronic proton pump inhibitors use was reported by 116 (82%) patients, of whom 24% took the medication incorrectly. Symptom control varied by symptom type: heartburn and thoracic pain showed the highest response rates (77% and 67% patients reporting partial or complete effectiveness, respectively), whereas other symptoms, such as regurgitation, dysphonia and globus remained poorly controlled (57%, 47% and 51% mild or no effectiveness, respectively). Despite patients reporting persistent reflux symptoms on proton pump inhibitor therapy, only 37% were prescribed prokinetics and 35% were prescribed mucosal protective agents as adjuvant therapy.

CONCLUSIONS

Proton pump inhibitors remain the cornerstone of reflux symptom management in systemic sclerosis but demonstrate limited effectiveness and frequent errors in administration. While patient satisfaction with heartburn control is acceptable, persistent esophageal and extra-esophageal symptoms suggest additional, non-acid-related mechanisms.