# E-Gastryal® + Magnesium Alginate Plus PPI vs. PPI Alone in GERD: Results from the GENYAL® Randomized Controlled Trial

## TL;DR

This study shows that combining E-Gastryal® with a PPI improves GERD symptom control and reduces the need for additional medications compared to PPI alone.

## Contribution

The study introduces E-Gastryal® + MgAlg as an effective combination therapy for GERD, showing both short-term and long-term benefits.

## Key findings

- The combination group used significantly fewer rescue medications than the PPI-only group.
- The combination therapy led to greater improvement in symptom and quality-of-life scores at week 4.
- Symptom relief was sustained over 26 weeks with continued use of E-Gastryal® + MgAlg alone.

## Abstract

Background: Up to one-third of patients with gastroesophageal reflux disease (GERD) have persistent symptoms despite proton-pump inhibitor (PPI) therapy. E-Gastryal® + MgAlg (Aurora Biofarma, Italy) is a mucosal protective agent that enhances barrier function against acid and non-acidic reflux. This study assessed its efficacy in combination with omeprazole versus omeprazole alone and as maintenance therapy. Methods: Patients with symptomatic GERD and Grade A reflux esophagitis confirmed by endoscopy were randomized to receive omeprazole 20 mg plus E-Gastryal® + MgAlg or omeprazole 20 mg alone. The primary endpoint was the number of rescue medications used over 28 days. Secondary endpoints included symptom relief and quality-of-life assessments using the Reflux Symptom Index (RSI), Gastroesophageal Reflux Disease Impact Scale (GIS), GERD-Health-Related Quality of Life (GERD-HRQL), and Global Assessment of Performance (IGAP). Results: Ninety-six patients were included. The combination group used significantly fewer rescue medications (mean: 21 vs. 40.9 tablets; p = 0.002). At week 4, the combination group showed greater improvement in RSI, GIS, and GERD-HRQL scores (p < 0.001). Symptom relief was sustained during weeks 5–26 with E-Gastryal® + MgAlg alone. Conclusions: E-Gastryal® + MgAlg combined with omeprazole improves symptom control compared to PPI monotherapy. Continued use as maintenance therapy supports its role in long-term GERD management (NCT04130659).