On-demand therapy with rabeprazole in nonerosive and erosive gastroesophageal reflux disease in clinical practice: effectiveness, health-related quality of life, and patient satisfaction.

On-demand therapy is effective for maintaining symptoms control in nonerosive gastroesophageal reflux disease (GERD). Our aim was to assess the clinical effectiveness of on-demand therapy with a proton pump inhibitor (PPI) in mild GERD (nonerosive and low-grade esophagitis), its impact on health-related quality of life (HRQoL), and the degree of patient satisfaction. Fifty-five patients (17 with nonerosive GERD and 38 with low-grade esophagitis) were treated with rabeprazole, 20 mg/day. The healed patients started on-demand therapy. We evaluated symptoms (clinical questionnaire), HRQoL (SF-36 questionnaire), and patient satisfaction (visual analogue scale). Of the 55 patients included, 51 started on-demand therapy for 6 months. Symptom control (heartburn <twice a week) was achieved in over 85% of the patients. The mean (SD) amount of PPI used was 0.3 (0.19) tablet/day. The patient satisfaction score at the end of the acute phase was 98 (range, 0-100) and remained high (90; range, 10-100) and stable during on-demand therapy. Short-term treatment normalized the HRQoL scores, which were subsequently maintained during on-demand therapy. On-demand therapy is useful for the clinical management of patients with mild GERD, allowing adequate symptoms control, limiting PPI consumption, and affording important patient satisfaction with normalization of HRQoL.