Background Gastroesophageal reflux disease (GERD) is caused by the abnormal reflux of the gastric contents into the esophagus. Many risk factors are considered as a cause of GERD. Nonsteroidal anti-inflammatory drugs (NSAIDs) consumption is regard as one cause of the development of GERD; but, there are few reports regarding the relationship between NSAIDs consumption and the development of GERD1. NSAIDs are commonly used to control pain, inflammation related to patients with rheumatoid arthritis (RA). Therefore, the prevalence of GERD in RA may be high because of high rate of NSAIDs consumption. However, there are few reports regarding as the development of GERD in RA2.
Objectives The purpose of this study was to examine the prevalence of GERD in RA patients and investigated the association between GERD and clinical factors.
Methods We investigated 378 outpatients with RA (70 males, 308 females). Three rheumatologist of orthopaedic surgery examined all patients. The presence or absence of GERD was evaluated by using GerdQ questionnaire. It is well known that GerdQ can be used to diagnose GERD with an accuracy similar to that of the gastroenterologist. When heartburn or acid regurgitation symptoms are observed more than once a week, the patients are diagnosed with GERD. The correlation between GERD and clinical factors such as age, sex, height, weight, BMI, disease duration, DAS28/DAS28-CRP/SDAI, Pt-VAS, and medication drugs (NSAIDs, steroid, bisphosphonate, and gatroprotective agents) were analyzed.
Results The GERD symptoms were observed in 96 of these 378 patients (25.4%). SDAI and patient's VAS were significantly higher in the GERD positive group than in the GERD negative group (p<0.05). DAS28 and DAS28-CRP were higher in the GERD positive group than in the GERD negative group, but these differences did not reach statistical significances. There was no statistical correlation between the presence or absence of GERD symptoms and the presence or absence of taking NSAIDs, steroid, and bisphosphonate.
Conclusions The prevalence of GERD in RA (25.4%) was higher than that in the Japanese healthy population (7.6-10.6%). The prevalence of GERD in RA was high and associated with Pt-VAS. Therefore, we should pay attention to the complication of GERD when the evaluation of disease activity of RA.
Cryer B, Luo X, Assaf AR, et al. Persistence with non-selective NSAIDs and celecoxib among patients with gastroesophageal reflux disease and osteoarthritis or rheumatoid arthritis. Curr Med Res Opin 2011; 27: 295-302
Miura Y, Fukuda K, Maeda T, et al. Gastroesophageal reflux disease in patients with rheumatoid arthritis. Mod Rheumatol 2013; Early Online: 1-5
Acknowledgements The authors thank to the patients who participated in this study.
Disclosure of Interest None declared
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