A greater response rate was found for cough and globus symptoms in individuals having atypical gastroesophageal reflux disease (GERD) following the eight-week proton pump inhibitor (PPI) treatment with dexlansoprazole in comparison with lansoprazole.

This study was performed to compare the efficacy of lansoprazole, (fast orally disintegrating PPI), and dexlansoprazole (dual delayed-release PPI) in individuals suffering from atypical GERD symptoms (hoarseness, globus, cough).

The  prospective, randomized, open-label trial incorporated 232 subjects having atypical GERD symptoms with a total reflux symptom index score > 10. Participants were randomly allocated to receive oral administration of 30 mg lansoprazole, once daily prior to breakfast or oral administration of 60 mg dexlansoprazole once daily prior to breakfast for eight weeks. Comparing the symptoms response rate after an eight-week PPI treatment between the two arms was the primary outcome parameter.

Following the eight-week PPI treatment, the dexlansoprazole-treated arm displayed a considerably greater response rate compared to the lansoprazole-treated arm in cough and globus, as shown in the table below:

As per the multivariate logistic regression assessment, the usage of dexlansoprazole, dyslipidemia presence, and typical GERD symptoms (heartburn and acid reflux) were found to significantly predict the symptom response for cough. The usage of dexlansoprazole and erosive esophagitis presence were found to predict the symptom response for globus. In this study, no predictor for treatment response to hoarseness was witnessed.

Compared to lansoprazole once daily, administration of dexlansoprazole once daily for eight weeks showed a substantially higher response rate in atypical GERD individuals having globus and cough.