OBJECTIVES: Proton pump inhibitors (PPIs) are the treatment of choice for gastroesophageal reflux disease (GERD), yet many patients experience persistent symptoms. To date, the burden of illness (BoI) among partial responders to PPI treatment is not well understood. METHODS: REMAIN-France was a multicentre, 12-month prospective study of adults with GERD who were newly identified as partial responders to optimised PPI treatment. BoI was evaluated at baseline, 3, 6, 9 and 12 months via patient-completed questionnaires, including the Reflux Symptom Questionnaire with 7-day recall (RESQ-7). Medical evaluations were completed at baseline, 6 and 12 months. Healthcare consumption was evaluated in terms of visits to a primary care physician (PCP) and gastroenterologist, number of endoscopies and days on prescribed GERD medication. All analyses were descriptive. RESULTS: A total of 262 patients were enrolled (mean age, 54y; 40.5% men), the majority of whom (n=226, 86%) completed the 12-month study. Using the RESQ-7 questionnaire, 32% of patients reported severe symptoms and 48% reported daily symptoms at baseline despite PPI treatment. Whilst continuing to receive prescribed GERD medication (most commonly daily PPIs), symptoms remained burdensome at 6 and 12 months and indicated a positive relationship with impaired quality of life (SF-36, EQ-5D) and decreased work productivity (WPAI-GERD). Between baseline and 6 months, the mean number of visits to a PCP and gastroenterologist among all patients was 1.9 and 0.5, respectively. For 7-12 months’ follow up the corresponding figures were 1.8 and 0.4, respectively. A total of 12 patients (4.6%) underwent endoscopy in the first 6 months of follow-up; thereafter, 10 patients (3.9%) underwent endoscopy between 7 and 12 months. CONCLUSIONS: In French patients with GERD who have persistent symptoms despite PPI therapy, the symptom burden is substantial and a positive relationship with impaired quality of life and decreased work productivity is indicated. Supported by AstraZeneca R&D, Mölndal, Sweden