Browsing by Author "Veterans General Hospital-Kaohsiung Taiwan"

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    Amplification-driven BCL6-suppressed cytostasis is mediated by transrepression of FOXO3 and post-translational modifications of FOXO3 in urinary bladder urothelial carcinoma
    (2020-01-01) Wen Ren Wu; Jen Tai Lin; Cheng Tang Pan; Ti Chun Chan; Chen Liang Liu; Wen Jeng Wu; Jim Jinn Chyuan Sheu; Bi Wen Yeh; Steven K. Huang; Jheng Yan Jhung; Meng Shin Hsiao; Chien Feng Li; Yow Ling Shiue; Chi Mei Medical Center; Kaohsiung Medical University Chung-Ho Memorial Hospital; Veterans General Hospital-Kaohsiung Taiwan; Faculty of Medicine, Ramathibodi Hospital, Mahidol University; Kaohsiung Medical University; National Sun Yat-Sen University Taiwan; National Health Research Institutes Taiwan
    © The author(s). Muscle-invasive urinary bladder urothelial carcinoma (UBUC) is a lethal disease for which effective prognostic markers and potential therapy targets are still lacking. Previous array comparative genomic hybridization identified that 3q27 is frequently amplified in muscle-invasive UBUCs, one candidate proto-oncogene, B-cell CLL/lymphoma 6 (BCL6), mapped to this region. We therefore aimed to explore its downstream targets and physiological roles in UBUC progression. Methods: Specimens from UBUC patients, NOD/SCID mice and several UBUC-derived cell lines were used to perform quantitative RT-PCR, fluorescence in situ hybridization immunohistochemistry, xenograft, gene stable overexpression/knockdown and a series of in vitro experiments. Results: Amplification of the BCL6 gene lead to upregulation of BCL6 mRNA and protein levels in a substantial set of advanced UBUCs. High BCL6 protein level significantly predicted poor disease-specific and metastasis-free survivals. Knockdown of the BCL6 gene in J82 cells inhibited tumor growth and enhanced apoptosis in the NOD/SCID xenograft model. In vitro experiments demonstrated that BCL6 inhibited cytostasis, induced cell migration, invasion along with alteration of the expression levels of several related regulators. At molecular level, BCL6 inhibited forkhead box O3 (FOXO3) transcription, subsequent translation and upregulation of phosphorylated/inactive FOXO3 through phosphoinositide 3-kinase (PI3K)/AKT serine/threonine kinase (AKT) and/or epidermal growth factor receptor (EGFR)/mitogen-activated protein kinase 1/2 (MAP2K1/2) signaling pathway(s). Two BCL6 binding sites on the proximal promoter region of the FOXO3 gene were confirmed. Conclusion: Overexpression of BCL6 served a poor prognostic factor in UBUC patients. In vivo and in vitro studies suggested that BCL6 functions as an oncogene through direct transrepression of the FOXO3 gene, downregulation and phosphorylation of the FOXO3 protein.
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    Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment
    (2020-03-01) Liang Kung Chen; Jean Woo; Prasert Assantachai; Tung Wai Auyeung; Ming Yueh Chou; Katsuya Iijima; Hak Chul Jang; Lin Kang; Miji Kim; Sunyoung Kim; Taro Kojima; Masafumi Kuzuya; Jenny S.W. Lee; Sang Yoon Lee; Wei Ju Lee; Yunhwan Lee; Chih Kuang Liang; Jae Young Lim; Wee Shiong Lim; Li Ning Peng; Ken Sugimoto; Tomoki Tanaka; Chang Won Won; Minoru Yamada; Teimei Zhang; Masahiro Akishita; Hidenori Arai; Seoul National University Bundang Hospital; Seoul Metropolitan Government - Seoul National University Borame Medical Center; National Yang-Ming University Taiwan; Ajou University, School of Medicine; National Center for Geriatrics and Gerontology - National Institute for Longevity Sciences; University of Tokyo; Veterans General Hospital-Kaohsiung Taiwan; Nagoya University School of Medicine; University of Tsukuba; Osaka University Faculty of Medicine; Veterans General Hospital-Taipei; Faculty of Medicine, Siriraj Hospital, Mahidol University; Peking Union Medical College Hospital; Chinese University of Hong Kong; Tan Tock Seng Hospital; Kyung Hee University; Beijing Hospital
    © 2019 AMDA – The Society for Post-Acute and Long-Term Care Medicine Clinical and research interest in sarcopenia has burgeoned internationally, Asia included. The Asian Working Group for Sarcopenia (AWGS) 2014 consensus defined sarcopenia as “age-related loss of muscle mass, plus low muscle strength, and/or low physical performance” and specified cutoffs for each diagnostic component; research in Asia consequently flourished, prompting this update. AWGS 2019 retains the previous definition of sarcopenia but revises the diagnostic algorithm, protocols, and some criteria: low muscle strength is defined as handgrip strength <28 kg for men and <18 kg for women; criteria for low physical performance are 6-m walk <1.0 m/s, Short Physical Performance Battery score ≤9, or 5-time chair stand test ≥12 seconds. AWGS 2019 retains the original cutoffs for height-adjusted muscle mass: dual-energy X-ray absorptiometry, <7.0 kg/m2 in men and <5.4 kg/m2 in women; and bioimpedance, <7.0 kg/m2 in men and <5.7 kg/m2 in women. In addition, the AWGS 2019 update proposes separate algorithms for community vs hospital settings, which both begin by screening either calf circumference (<34 cm in men, <33 cm in women), SARC-F (≥4), or SARC-CalF (≥11), to facilitate earlier identification of people at risk for sarcopenia. Although skeletal muscle strength and mass are both still considered fundamental to a definitive clinical diagnosis, AWGS 2019 also introduces “possible sarcopenia,” defined by either low muscle strength or low physical performance only, specifically for use in primary health care or community-based health promotion, to enable earlier lifestyle interventions. Although defining sarcopenia by body mass index–adjusted muscle mass instead of height-adjusted muscle mass may predict adverse outcomes better, more evidence is needed before changing current recommendations. Lifestyle interventions, especially exercise and nutritional supplementation, prevail as mainstays of treatment. Further research is needed to investigate potential long-term benefits of lifestyle interventions, nutritional supplements, or pharmacotherapy for sarcopenia in Asians.
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    Consensus recommendations by the asian pacific society of cardiology: Optimising cardiovascular outcomes in patients with type 2 diabetes
    (2021-01-01) Jack Wei Chieh Tan; David Sim; Junya Ako; Wael Almahmeed; Mark E. Cooper; Jamshed J. Dalal; Chaicharn Deerochanawong; David Wei Chun Huang; Sofian Johar; Upendra Kaul; Sin Gon Kim; Natalie Koh; Alice Pik Shan Kong; Rungroj Krittayaphong; Bernard Kwok; Bien J. Matawaran; Quang Ngoc Nguyen; Loke Meng Ong; Jin Joo Park; Yongde Peng; David K.L. Quek; Ketut Suastika; Norlela Sukor; Boon Wee Teo; Chee Kiang Teoh; Jian Zhang; Eugenio B. Reyes; Su Yen Goh; Siriraj Hospital; Chinese Academy of Medical Sciences & Peking Union Medical College; Cleveland Clinic Abu Dhabi; Hospital Pulau Pinang; Seoul National University Bundang Hospital; Raja Isteri Pengiran Anak Saleha Hospital; University of the Philippines Manila; University of Santo Tomas, Manila; Hanoi Medical University; National Yang-Ming University Taiwan; Universitas Udayana; Batra Hospital India; Korea University College of Medicine; Hospital Canselor Tuanku Muhriz UKM; NUS Yong Loo Lin School of Medicine; Shanghai Jiao Tong University; Veterans General Hospital-Kaohsiung Taiwan; Institut Jantung Negara Kuala Lumpur; Monash University; Singapore General Hospital; Pantai Holdings Sdn Bhd; Kitasato University; Rajavithi Hospital; National Heart Centre, Singapore; Fooyin University Taiwan; Chinese University of Hong Kong; Sengkang General Hospital; Farrer Park Hospital; Kokilaben Hospital
    The Asian Pacific Society of Cardiology convened a consensus statement panel for optimising cardiovascular (CV) outcomes in type 2 diabetes, and reviewed the current literature. Relevant articles were appraised using the Grading of Recommendations, Assessment, Development and Evaluation system, and consensus statements were developed in two meetings and were confirmed through online voting. The consensus statements indicated that lifestyle interventions must be emphasised for patients with prediabetes, and optimal glucose control should be encouraged when possible. Sodium–glucose cotransporter 2 inhibitors (SGLT2i) are recommended for patients with chronic kidney disease with adequate renal function, and for patients with heart failure with reduced ejection fraction. In addition to SGLT2i, glucagon-like peptide-1 receptor agonists are recommended for patients at high risk of CV events. A blood pressure target below 140/90 mmHg is generally recommended for patients with type 2 diabetes. Antiplatelet therapy is recommended for secondary prevention in patients with atherosclerotic CV disease.
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    COVID-19 and Older People in Asia: AWGS Calls to Actions
    (2020-01-01) Wee Shiong Lim; Chih Kuang Liang; Prasert Assantachai; Tung Wai Auyeung; Lin Kang; Wei Ju Lee; Jae Young Lim; Ken Sugimoto; Masahiro Akishita; Shu Lih Chia; Ming Yueh Chou; Yew Yoong Ding; Katsuya Iijima; Hak Chul Jang; Shuji Kawashima; Miji Kim; Taro Kojima; Masafumi Kuzuya; Jenny Lee; Sang Yoon Lee; Yunhwan Lee; Li Ning Peng; Ninie Y. Wang; Yin Wei Wang; Chang Won Won; Jean Woo; Liang Kung Chen; Hidenori Arai; Seoul National University Bundang Hospital; Seoul Metropolitan Government - Seoul National University Borame Medical Center; National Yang-Ming University Taiwan; Ajou University, School of Medicine; National Center for Geriatrics and Gerontology - National Institute for Longevity Sciences; University of Tokyo; Veterans General Hospital-Kaohsiung Taiwan; Nagoya University Graduate School of Medicine; Osaka University Faculty of Medicine; Veterans General Hospital-Taipei; Faculty of Medicine, Siriraj Hospital, Mahidol University; Peking Union Medical College Hospital; Chinese University of Hong Kong; Tan Tock Seng Hospital; Kyung Hee University; Pinetree Care Group; Ministry of Health and Welfare
    This article is protected by copyright. All rights reserved. The coronavirus disease 2019 (COVID-19) pandemic has casted a huge impact on global public health and economy. In this challenging situation, older people are vulnerable to the infection and the secondary effects of the pandemic and need special attentions. To evaluate the impacts of COVID-19 on older people, it is important to balance the successful pandemic control and active management of secondary consequences. These considerations are especially salient in the Asian context, with its diversity among countries in terms of sociocultural heritage, healthcare setup and availability of resources. Thus, the Asian Working Group for Sarcopenia summarized the considerations of Asian countries focusing on responses and difficulties in each country, impacts of health inequity related to COVID-19 pandemic and proposed recommendations for older people which are germane to the Asian context. More innovative services should be developed to address the increasing demands for new approaches to deliver health care in the difficult times and to establish resilient health care systems for older people. This article is protected by copyright. All rights reserved.
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    Impact of Alzheimer's Disease in Nine Asian Countries
    (2016-06-15) Yuan Han Yang; Kenichi Meguro; Sang Yun Kim; Yong Soo Shim; Xin Yu; Christopher Li Hsian Chen; Huali Wang; Linda Lam; Vorapun Senanarong; Jacqueline Dominguez; Pei Yuan Lu; Yu Te Lin; Chaur Jong Hu; Pai Yi Chiu; Jong Ling Fuh; Wen Fu Wang; Bao Cheng Yu; Tao Li; Ming Wei Wang; Rocksy Fransisca V. Situmeang; Jae Won Jang; Jing Zhang; Wai Chi Chan; Yu Ying Zhou; Hui Ling Lou; Li Zhang; Min Ye; Xu Chen; Kaohsiung Medical University; Tohoku University School of Medicine; Seoul National University Bundang Hospital; Seoul National University; The Catholic University of Korea; Peking University; National University Health System; Yong Loo Lin School of Medicine; Chinese University of Hong Kong; Mahidol University; St. Luke's Medical Center Quezon City; Hebei General Hospital; Veterans General Hospital-Kaohsiung Taiwan; Taipei Medical University; Lin Shin Hospital; Veterans General Hospital-Taipei; National Yang-Ming University Taiwan; Changhua Christian Hospital Taiwan; Central Taiwan University of Science and Technology; Bethune International Peace Hospital of the PLA; Hebei Medical University; Universitas Pelita Harapan; Kangwon National University; Beijing Shijitan General Hospital; The University of Hong Kong; Tianjin Huanhu Hospital; Guangzhou First Municipal People's Hospital; Nanjing Brain Hospital; Nanjing BenQ Hospital; Shanghai Eighth People's Hospital
    © 2016 S. Karger AG, Basel. Background: Asia will soon have the majority of demented patients in the world. Objective: To assess dementia using a uniform data system to update the current status of dementia in Asia. Methods: A uniformed data set was administered in Taiwan, China, Hong Kong, Korea, Japan, Philippines, Thailand, Singapore, and Indonesia to gather data with regard to Alzheimer's disease (AD) and its related issues for these countries. Results: In total, 2,370 AD patients and their caregivers were recruited from 2011 to 2014. The demographic characteristics of these patients and the relationships between patients and caregivers were different among individuals in these countries (p < 0.001). Of note, the family history for having dementia was 8.2% for females in contrast to 3.2% for males. Conclusion: Our study highlighted the differences in dementia assessment and care in developing versus developed countries. Greater effort with regard to studying dementia, especially in developing countries, is necessary.
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    Primary Cutaneous NK/T-cell lymphoma, nasal type and cd56-positive peripheral t-cell lymphoma A cellular lineage and clinicopathologic study of 60 patients from Asia
    (2015-01-20) Katsuyoshi Takata; Min Eui Hong; Panitta Sitthinamsuwan; Florence Loong; Soo Yong Tan; Jau Yu Liau; Pin Pen Hsieh; Siok Bian Ng; Sheau Fang Yang; Tawatchai Pongpruttipan; Sanya Sukpanichnant; Yok Lam Kwong; Young Hyeh Ko; Yung Tsu Cho; Wee Joo Chng; Takashi Matsushita; Tadashi Yoshino; Shih Sung Chuang; Okayama University Medical School; Kanazawa University School of Medicine; Samsung Medical Center; Samsung Medical Center, Sungkyunkwan University; Mahidol University; Departments of Pathology; Queen Mary Hospital Hong Kong; Singapore General Hospital; National University Health System; Cancer Science Institute of Singapore; National Taiwan University Hospital; Taipei Medical University; Veterans General Hospital-Kaohsiung Taiwan; Kaohsiung Medical University Chung-Ho Memorial Hospital
    Copyright © 2014 by Lippincott Williams & Wilkins. Primary cutaneous, extranodal natural killer/T-cell lymphoma, nasal type (PC-ENKTL), is a rare Epstein-Barr virus (EBV)-associated neoplasm with poorly defined clinicopathologic features. We performed a multinational retrospective study of PC-ENKTL and CD56-positive EBVnegative peripheral T-cell lymphoma (PC-CD56+PTCL) in Asia in an attempt to elucidate their clinicopathologic features. Using immunohistochemistry for T-cell receptors (TCRs), in situ hybridization for EBV, and TCR gene rearrangement, we classified 60 tumors into 51 with PC-ENKTL (20 of NK-cell, 17 T-cell, and 14 indeterminate lineages) and 9 with PCCD56+ PTCL. Tumors of T-cell origin accounted for 46% of PC-ENKTLs with half of these cases being TCR-silent. As compared with T-lineage tumors, PC-ENKTLs of NK-cell lineage had more frequent involvement of regional lymph nodes and more frequently CD8-negative and CD56-positive. Cases of PC-ENKTL showed more frequent tumor necrosis, younger age, and a higher frequency of CD16 and CD30 expression than cases of PC-CD56+PTCL. CD56-positive T-lineage PCENKTL tumors (n=8) had more localized disease in the TNM (tumor-node-metastasis) staging and were more often of gd Tcell origin compared with cases of PC-CD56+PTCL (n=9). PC-ENKTLs and PC-CD56+PTCLs were equally aggressive, with a 5-year overall survival rate of 25%. Tumor necrosis and CD16 expression may serve as useful surrogates for differentiating PC-ENKTL from PC-CD56+PTCL. A single lesion, an elevated lactate dehydrogenase level, and the presence of B symptoms were independent poor prognostic factors for PCENKTL in multivariate analysis. Further studies with more cases are warranted to delineate the clinicopathologic features and significance of EBV in these rare lymphomas.
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    Sarcopenia in Asia: Consensus report of the Asian working group for sarcopenia
    (2014-01-01) Liang Kung Chen; Li Kuo Liu; Jean Woo; Prasert Assantachai; Tung Wai Auyeung; Kamaruzzaman Shahrul Bahyah; Ming Yueh Chou; Liang Yu Chen; Pi Shan Hsu; Orapitchaya Krairit; Jenny S.W. Lee; Wei Ju Lee; Yunhwan Lee; Chih Kuang Liang; Panita Limpawattana; Chu Sheng Lin; Li Ning Peng; Shosuke Satake; Takao Suzuki; Chang Won Won; Chih Hsing Wu; Si Nan Wu; Teimei Zhang; Ping Zeng; Masahiro Akishita; Hidenori Arai; Veterans General Hospital-Taipei; Chinese University of Hong Kong; Mahidol University; University of Malaya; Veterans General Hospital-Kaohsiung Taiwan; Taichung Hospital; Ajou University, School of Medicine; Khon Kaen University; Veterans General Hospital-Taichung Taiwan; National Center for Geriatrics and Gerontology - National Institute for Longevity Sciences; Kyung Hee University; National Cheng Kung University Hospital; Ministry of Health of People's Republic of China; Kyoto University Faculty of Medicine; University of Tokyo
    Sarcopenia, a newly recognized geriatric syndrome, is characterized by age-related decline of skeletal muscle plus low muscle strength and/or physical performance. Previous studies have confirmed the association of sarcopenia and adverse health outcomes, such as falls, disability, hospital admission, long term care placement, poorer quality of life, and mortality, which denotes the importance of sarcopenia in the health care for older people. Despite the clinical significance of sarcopenia, the operational definition of sarcopenia and standardized intervention programs are still lacking. It is generally agreed by the different working groups for sarcopenia in the world that sarcopenia should be defined through a combined approach of muscle mass and muscle quality, however, selecting appropriate diagnostic cutoff values for all the measurements in Asian populations is challenging. Asia is a rapidly aging region with a huge population, so the impact of sarcopenia to this region is estimated to be huge as well. Asian Working Group for Sarcopenia (AWGS) aimed to promote sarcopenia research in Asia, and we collected the best available evidences of sarcopenia researches from Asian countries to establish the consensus for sarcopenia diagnosis. AWGS has agreed with the previous reports that sarcopenia should be described as low muscle mass plus low muscle strength and/or low physical performance, and we also recommend outcome indicators for further researches, as well as the conditions that sarcopenia should be assessed. In addition to sarcopenia screening for community-dwelling older people, AWGS recommends sarcopenia assessment in certain clinical conditions and healthcare settings to facilitate implementing sarcopenia in clinical practice. Moreover, we also recommend cutoff values for muscle mass measurements (7.0 kg/m2 for men and 5.4 kg/m2 for women by using dual X-ray absorptiometry, and 7.0 kg/m2 for men and 5.7 kg/m2 for women by using bioimpedance analysis), handgrip strength (<26 kg for men and <18 kg for women), and usual gait speed (<0.8 m/s). However, a number of challenges remained to be solved in the future. Asia is made up of a great number of ethnicities. The majority of currently available studies have been published from eastern Asia, therefore, more studies of sarcopenia in south, southeastern, and western Asia should be promoted. On the other hand, most Asian studies have been conducted in a cross-sectional design and few longitudinal studies have not necessarily collected the commonly used outcome indicators as other reports from Western countries. Nevertheless, the AWGS consensus report is believed to promote more Asian sarcopenia research, and most important of all, to focus on sarcopenia intervention studies and the implementation of sarcopenia in clinical practice to improve health care outcomes of older people in the communities and the healthcare settings in Asia. © 2014 American Medical Directors Association, Inc.
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    Sorafenib suppresses TGF-β responses by inducing caveolae/lipid raft-mediated internalization/degradation of cell-surface type II TGF-β receptors: Implications in development of effective adjunctive therapy for hepatocellular carcinoma
    (2018-08-01) Chih Ling Chung; Shih Wei Wang; Wei Chih Sun; Chih Wen Shu; Yu Chen Kao; Meng Shin Shiao; Chun Lin Chen; Veterans General Hospital-Kaohsiung Taiwan; Faculty of Medicine, Ramathibodi Hospital, Mahidol University; National Sun Yat-Sen University Taiwan
    © 2018 Elsevier Inc. Sorafenib is the only FDA approved drug for the treatment of advanced hepatocellular carcinoma (HCC) and other malignancies. Studies indicate that TGF-β signalling is associated with tumour progression in HCC. Autocrine and paracrine TGF-β promotes tumour growth and malignancy by inducing epithelial-mesenchymal transition (EMT). Sorafenib is believed to antagonize tumour progression by inhibiting TGF-β-induced EMT. It improves survival of patients but HCC later develops resistance and relapses. The underlying mechanism of resistance is unknown. Understanding of the molecular mechanism of sorafenib inhibition of TGF-β-induced signalling or responses in HCC may lead to development of adjunctive effective therapy for HCC. In this study, we demonstrate that sorafenib suppresses TGF-β responsiveness in hepatoma cells, hepatocytes, and animal liver, mainly by downregulating cell-surface type II TGF-β receptors (TβRII) localized in caveolae/lipid rafts and non-lipid raft microdomains via caveolae/lipid rafts-mediated internalization and degradation. Furthermore, sorafenib-induced downregulation and degradation of cell-surface TβRII is prevented by simultaneous treatment with a caveolae disruptor or lysosomal inhibitors. On the other hand, sorafenib only downregulates cell-surface TβRII localized in caveolae/lipid rafts but not localized in non-lipid raft microdomains in hepatic stellate cells. These results suggest that sorafenib inhibits TGF-β signalling mainly by inducing caveolae/lipid raft-mediated internalization and degradation of cell-surface TβR-II in target cells. They may also imply that treatment with agents which promote formation of caveolae/lipid rafts, TGF-β receptor kinase inhibitors (e.g., LY2157299) or TGF-β peptide antagonists (by liver-targeting delivery) may be considered as effective adjunct therapy with sorafenib for HCC.
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    Tuberculous tenosynovitis and bursitis: Imaging findings in 21 cases
    (1996-01-01) Suphaneewan Jaovisidha; Clement Chen; Kyung Nam Ryu; Pimjai Siriwongpairat; Patchrin Pekanan; David J. Sartoris; Donald Resnick; VA Medical Center; Mahidol University; Veterans General Hospital-Kaohsiung Taiwan; University of California, San Diego
    PURPOSE: To describe imaging features of tuberculous tenosynovitis and bursitis with various imaging methods. MATERIALS AND METHODS: Twenty-one patients with surgically and/or pathologically proved tuberculosis of the tendon sheaths or bursae were evaluated. Routine radiography, arthrography, computed tomography (CT), and magnetic resonance (MR) imaging were used in some or all of the patients. RESULTS: Twelve patients had tuberculous tenosynovitis, and nine had bursitis. Tuberculous tenosynovitis most commonly involved the tendon sheaths of the hand and wrist, whereas bursitis occurred most frequently about the hip, especially in the trochanteric bursa. All cases of tuberculous tenosynovitis or bursitis showed soft-tissue swelling on plain radiographs, with calcification demonstrated in three of nine (33%) cases. CT and MR imaging allowed evaluation of all forms of tuberculous tenosynovitis (hygromatous, serofibrinous, and fungoid forms), whereas tuberculous bursitis exhibited two patterns of involvement: either a distended bursa or multiple small abscesses. Contrast material-enhanced radiography (ie, arthrography) helped delineate communication between the affected structures. CONCLUSION: All imaging methods can provide complementary information that is helpful for determination of therapy. MR imaging seems to be superior in evaluating the extent of the lesion, particularly in soft tissue.
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    Unmet treatment needs of gastroesophageal reflux disease in Asia: Gastroesophageal reflux disease in Asia Pacific Survey
    (2014-01-01) Khean Lee Goh; Myung Gyu Choi; William Ping I. Hsu; Hoon Jai Chun; Varocha Mahachai; Udom Kachintorn; Somchai Leelakusolvong; Nayoung Kim; Abdul Aziz Rani; Benjamin Cy Wong; Justin Wu; Cheng Tang Chiu; Romeo Chu; Vikram Shetty; Joseph C. Bocobo; Melchor M. Chan; Jaw Town Lin; University of Malaya; The Catholic University of Korea; Korea University, College of Medicine; Seoul National University Bundang Hospital; Veterans General Hospital-Kaohsiung Taiwan; Chang Gung Memorial Hospital; Fu Jen Catholic University; Chulalongkorn University; Mahidol University; Universitas Indonesia; The University of Hong Kong; Chinese University of Hong Kong; Takeda Pharmaceuticals (Asia Pacific) Pte Ltd; St. Luke's College of Medicine-William H. Quasha Memorial; University of Santo Tomas Hospital
    © 2014 Wiley Publishing Asia Pty Ltd and Journal of Gastroenterology and Hepatology Foundation. Background and Aim: Data on patient satisfaction with proton pump inhibitor (PPI) therapy for gastroesophageal reflux disease (GERD) are scarce in Asia. The perspectives of Asian patients with GERD and their satisfaction with PPI therapy were investigated. Methods: The GERD in Asia Pacific Survey (GAPS) was conducted from December 2011 to March 2012. Patients aged 21-55 years with self-reported doctor-diagnosed GERD, who had experienced symptoms in the previous 12 months, and were currently taking PPIs were enrolled. After a pilot study, a questionnaire was completed by respondents from six Asian countries during face-to-face interviews. Results: A total of 450 patients with GERD participated in the GAPS. Although the respondents generally complied with treatment, response to therapy was only partially successful. Most respondents indicated that PPIs eliminated pain (72%), took effect within 30min (76%), provided sustained relief (73%), and provided nocturnal relief (77%). However, 45% of respondents reported limited improvement in nocturnal symptoms, and 49% continued to take adjunctive therapy to manage their symptoms. After treatment, respondent's "well-being" had improved. However, GERD still had a negative impact on well-being for 76% of respondents after treatment, compared with 94% before treatment. Conclusions: Asian patients reported a negative impact of GERD on their daily lives. Many respondents continued to experience symptoms despite reporting good compliance with PPI therapy, emphasizing the shortcomings of currently available therapy for GERD. This survey is the first to highlight Asian patients' perspectives of GERD and PPI therapy, and provides a platform for further evaluation.