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Erosive oesophagitis with particular reference to Asians: authors’ reply

SIRS, We thank Goh et al. for their interest in our recent article, in which we reported less severe baseline erosive oesophagitis (EO) but significantly lower rates of EO healing after 8 weeks of therapy with proton pump inhibitors (PPIs) in non-white vs. white patients with gastro-oesophageal reflux disease (GERD). We did not evaluate rates of EO healing with PPIs in Asian patients specifically; however, 6.1% of patients in the non-white population were of Asian origin. Goh et al. highlighted a study that reported healing in 91% of patients with Los Angeles (LA) grade A–D EO after 8 weeks of therapy with a PPI; however, only 5.9% of that patient population were Asian. In our study, four of the five individual clinical studies from which EO healing was analysed retrospectively by race included patients with all LA grades, and healing rates after 8 weeks of treatment with PPIs were similar to those reported by Goh et al. (84.2–94.1% in predominantly white populations). We agree that additional studies in Asian patients, perhaps in Malaysian populations with diverse ethnicities, are warranted to characterise the effects of PPIs on EO healing by race. If confirmed, personalised medicine may allow physicians to tailor choices of PPI, dosing and duration of therapy for GERD based on CYP2C19 polymorphisms and other genetic factors that may vary with race.