Efficacy of Diltiazem combined with Lansoprazole in patients with
Jackhammer esophagus: a single center, randomized, open-label trial.
Abstract
Background Medical treatment plays a main role in the treatment of
Jackhammer esophagus (JE). The efficacy of calcium channel blockers
(CCBs) combined with proton pump inhibitors (PPIs) in the treatment of
JE has not been established. Methods This 8-week randomized, open-label
study was conducted in an outpatient setting in China. Patients with
symptomatic JE were randomly assigned to receive diltiazem combined with
lansoprazole (DL group) or diltiazem alone (D group). The primary
outcome was the response rate after 8 weeks. Secondary outcomes included
symptoms, quality of life, manometric pattern and reflux status. Key
Results Forty patients were randomized, 38 (95.0%) of whom completed
the study (20 patients in the DL group, and 18 were randomized to the D
group). A higher response rate was found in the DL group than in the D
group (85.0% vs. 55.0%, p= 0.038). All secondary outcomes, including
overall symptom control, quality of life, and reflux control, were
significantly better in the DL group than in the D group after 8 weeks
(p<0.05), except the distal contractile integral (DCI)
(p=0.274). Conclusions Diltiazem combined with lansoprazole is superior
to diltiazem alone in obtaining treatment response and correcting
abnormal reflux situations in patients with symptomatic JE.