Use of a prokinetic drug (itopride) in combination with proton pump inhibitors in the treatment of gastroesophageal reflux disease. An observational study

Objective:
The aim of the study was to explore therapeutic schemes used by primary healthcare (PHC) physicians in the treatment of gastroesophageal reflux disease (GERD) with particular emphasis on proton pump inhibitors (PPI) combined therapy with itopride – Prokit. The place of the itopride in therapy and the impact of combined therapy on the occurrence and severity of the symptoms of gastroesophageal reflux disease was assessed.

Material and methods:
The observational study was conducted among PHC physicians across the country in the period from November 2023 to October 2024. It included 7561 GERD patients. Adult patients with GERD, for whom physicians independently decided to implement combined therapy, were included in the study. The study consisted of a single investigator questionnaire (completed once before the start of the study) and a questionnaire for the patient divided into three parts corresponding to three consecutive visits (the interval between visits was about 5 weeks (±7 days, depending on the doctor’s decision). Data were collected on occurrence and severity of the symptoms of GERD, diagnostics, diseases and accompanying conditions, as well as pharmacological treatment.

Results:
The analysis revealed a statistically significant reduction in GERD symptom severity during the study. At the first visit, the highest severity was observed for heartburn, retrosternal burning sensation, epigastric discomfort, regurgitation, and vomiting, with an average symptom severity exceeding 2 points on a scale of 0 to 5. By the second visit, the average severity of all symptoms decreased to below 1, and by the third visit, to below 0.5.

Conclusions:
In the course of three visits, a reduction in all GERD symptoms was observed, and for most of them the change was statistically significant. The combined therapy used (PPI + itopride) has been highly rated in terms of its tolerance by patients.