Acid pump blockers: what are their current therapeutic roles?

Arens, M.

doi:10.1016/0950-3528(93)90033-o

Cited by 10 publications

(11 citation statements)

References 127 publications

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“…The greatest advantage for omeprazole over H2-antagonists has been found by all authors in patients with reflux oesophagitis: after 4 and 8 weeks' treatment there was a 30 to 40% advantage in healing rate for omeprazole 20mg and a greater than 40% advantage for omeprazole 40mg (Arens & Dent 1993;Blum 1990;Holt & Howden 1991;Maton 1991). The advantage of omeprazole regarding relief from heartburn was 40 to 50%.…”

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confidence: 89%

“…In chronic gastric ulcer the advantage in endoscopically proven healing rate of omeprazole treatment over cimetidine, ranitidine or famotidine was less marked: 10 to 15% after 4 and 8 weeks (Arens & Dent 1993;Blum 1990;Holt & Howden 1991;Maton 1991). Omeprazole 40mg daily was clearly superior to 20mg daily (Walan et al 1989).…”

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confidence: 95%

“…In duodenal ulcer the advantage for omeprazole in endoscopically proven healing rate was apparent after 2 weeks (15 to 30%) and 4 weeks (5 to 20%) against different Hz-antagonists (Arens & Dent 1993;Maton 1991). A meta-analysis of 11 published studies involving 2361 patients with duodenal ulcer has shown that after 2 weeks 71 % of patients were symptom-free with omeprazole 20mg daily compared with 58% of ranitidine 300 mg/day recipients (Blum 1990).…”

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confidence: 97%

“…The therapeutic advantage for omeprazole over H2-antagonists was greatest in the first 2 weeks of treatment and was less marked after 4 weeks, although still significant in most studies. Comprehensive tables and graphs, summarising the results and references of the different comparative trials can be found in recent reviews (Arens & Dent 1993;Blum 1990;Holt & Howden 1991;Maton 1991). Comparison is sometimes difficult because of different dosage regimens (omeprazole 20 and 40mg once daily vs cimetidine 800, 1200 or 1600 mg/day in divided doses; ranitidine 150mg twice daily or 300mg once daily; famotidine 20mg twice daily or 40mg once daily).…”

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confidence: 98%

“…Excellent summaries and meta-analyses of the numerous comparative studies against different H2-receptor antagonists have been published in the last 3 years (Arens & Dent 1993;Blum 1990;Holt & Howden 1991a;Maton 1991).…”

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confidence: 99%

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Risk-Benefit Assessment of Omeprazole in the Treatment of Gastrointestinal Disorders

Creutzfeldt

1994

Drug Safety

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For the treatment of duodenal and gastric ulcer and reflux oesophagitis, especially erosive oesophagitis, omeprazole has an advantage over histamine H2-receptor antagonists because it heals significantly more patients significantly faster. Adverse effects have been observed during short term treatment with the same frequency as during treatment with H2-antagonists. Also, maintenance treatment with omeprazole of reflux oesophagitis is significantly superior to H2-antagonist therapy. During long term treatment for up to 8 years no further drug-related adverse effects have been observed. Moderate hypergastrinaemia occurs in some patients, especially if an omeprazole dosage of 40 mg/day is needed. A slight increase of the agyrophil (endocrine) cell volume density and an extension of micronodular hyperplasia in the oxyntic mucosa after several years of omeprazole treatment seem to be related to the severity of the corpus gastritis and not to drug-induced hypergastrinaemia, because similar changes have been observed in equal frequency in patients not receiving anti-secretory drugs. Theoretical arguments against long term treatment with potent acid-suppressing drugs, such as the possible consequences of gastric bacterial overgrowth or hypergastrinaemia, are not supported by clinical observations and epidemiological data and are, therefore, speculative.

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confidence: 89%

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confidence: 95%

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confidence: 97%

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confidence: 98%

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confidence: 99%

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Risk-Benefit Assessment of Omeprazole in the Treatment of Gastrointestinal Disorders

Creutzfeldt

1994

Drug Safety

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Proton Pump Inhibitors and Acid‐Related Diseases

Sachs

1997

Pharmacotherapy

147

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Proton pump inhibitors (PPIs) are targeted to the gastric acid pump, H+,K+‐adenosine triphosphatase (ATPase). The drugs accumulate in the acid space of the parietal cell and convert to active sulfenamide by an acid‐catalyzed reaction. Consequent covalent inhibition of H+,K+‐ATPase blocks the final step of acid secretion, hence the PPIs omeprazole, lansoprazole, and pantoprazole are more effective than histamine2‐receptor antagonists (H2RAs) in controlling acid secretion. Preclinical short‐ and long‐term clinical surveillance data show these drugs to be well tolerated and safe. The PPIs heal the lesions of gastroesophageal reflux disease and lessen symptoms more effectively and more quickly than the H2RAs, and are effective' and faster acting for peptic ulcer disease. Helicobacter pylori is causally implicated in the majority of peptic ulcers and in atrophic gastritis. Since PPIs, but not H2RAs, are synergistic with antibiotics in eradicating H. pylori, their use is appropriate in all acid‐related diseases since all patients who are H. pylori positive require eradication as well as healing.

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Erkrankungen des Magens und des Zwölffingerdarms

Arnold¹

1999

Therapie Innerer Krankheiten

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Acid pump blockers: what are their current therapeutic roles?

Cited by 10 publications

References 127 publications

Risk-Benefit Assessment of Omeprazole in the Treatment of Gastrointestinal Disorders

Risk-Benefit Assessment of Omeprazole in the Treatment of Gastrointestinal Disorders

Proton Pump Inhibitors and Acid‐Related Diseases

Erkrankungen des Magens und des Zwölffingerdarms

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