Acid suppression in duodenal ulcer: a meta-analysis to define optimal dosing with antisecretory drugs.

Jones, D. E.; Howden, Colin W.; Burget, D. W.; Kerr, G. D.; Hunt, Richard H.

doi:10.1136/gut.28.9.1120

Cited by 255 publications

(78 citation statements)

References 21 publications

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“…8 It thus appears that for many patients the greater level of acid supression achieved with omeprazole is required for the relief of symptoms. 11 There is a widespread belief that mild symptoms equate to mild disease, and patients with relatively mild symptoms are often treated with a less effective treatment perceived by the physician to be appropriate for this group of patients. 1 However, this study supports the observations reported previously that mild symptoms do not equate to mild disease.…”

Section: Discussionmentioning

confidence: 99%

Omeprazole is more effective than cimetidine for the relief of all grades of gastro‐oesophageal reflux disease‐associated heartburn, irrespective of the presence or absence of endoscopic oesophagitis

Bate

Green

Axon

et al. 1997

Aliment Pharmacol Ther

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Background: Previous studies have demonstrated greater efficacy for omeprazole compared with cimetidine in patients with endoscopically verified oesophagitis, but excluded the substantial group of gastro‐oesophageal reflux disease (GERD) patients with reflux symptoms but without endoscopic abnormality. This prospective, randomized, double‐blind study compared omeprazole and cimetidine in the treatment of GERD‐associated heartburn both in patients with symptomatic non‐ulcerative oesophagitis and in those with heartburn but without oesophagitis. Methods: A total of 221 patients with heartburn and oesophageal mucosa grade 0 (normal, n = 51), 1 (no macroscopic erosions, n = 52), 2 (isolated erosions, n = 97) or 3 (confluent erosions, n = 21) were randomized to receive double‐blind either omeprazole 20 mg daily or cimetidine 400 mg q.d.s. for a period of 4 weeks. Those still symptomatic after 4 weeks of treatment received omeprazole 20 mg daily for a further 4 weeks. Results: There was no correlation between severity of heartburn and endoscopic grade at entry (correlation coefficient = 0.196). After 4 weeks of treatment, the proportion of patients in whom heartburn was controlled (no more than mild symptoms on no more than 1 day in the previous 7) on omeprazole (66%; 74/112) was more than double that on cimetidine (31%; 34/109) (P < 0.0001). There was no significant difference between the relief of heartburn in the 47% of patients without unequivocal oesophagitis (endoscopic grade 0 or 1) and in the 53% of patients with erosive oesophagitis (grade 2 or 3) (P = 0.31). Only treatment with omeprazole (P < 0.0001) and lower severity of heartburn at entry (P < 0.01) were significant in predicting heartburn relief. Amongst those patients requiring an additional 4 weeks of treatment with omeprazole, 67% (54/81) reported that their heartburn was controlled after 8 weeks of treatment. Conclusion: We conclude that omeprazole is superior to cimetidine for the relief of all grades of heartburn in GERD, whether or not the patient has unequivocal endoscopic oesophagitis.

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Section: Discussionmentioning

confidence: 99%

Omeprazole is more effective than cimetidine for the relief of all grades of gastro‐oesophageal reflux disease‐associated heartburn, irrespective of the presence or absence of endoscopic oesophagitis

Bate

Green

Axon

et al. 1997

Aliment Pharmacol Ther

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“…peptic ulcer, re¯ux oesophagitis), intragastric pH should be elevated above 3 or 4 for a certain period of time (e.g. 16 h) to achieve rapid and optimal healing 20,21 and second, acid suppression is needed for the synergistic action of the concomitantly given antibiotics for eradicating H. pylori. 9,19 Thereby it remains questionable whether drug-speci®c properties or the extent and duration of acid suppression affect eradication and which patient factors contribute to the large variability.…”

Section: Discussionmentioning

confidence: 99%

Age‐dependent eradication of Helicobacter pylori with dual therapy

Treiber

Ammon

Klotz

1997

Aliment Pharmacol Ther

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A causative role is now accepted for Helicobacter pylori for the development of erosive gastritis, duodenal and gastric ulcer. Eradication of the infection results in cure of erosive gastritis and a stable remission of peptic ulcer. During the last few years different treatment regimens have been tried, of which omeprazole and amoxycillin have been the most frequently used because this dual therapy is simple (b.d. dosing for 2 weeks) and welltolerated. However, the eradication rates vary widely (10±80%) and the decisive factors in¯uencing the ef®cacy remain unclear. 1, 2Based on experience with classical triple therapy (bismuth salt + two antibiotics), age might be considered as an important factor. However, although one trial reported an association between H. pylori eradication rate and advanced age, 3 another study could not . Intragastric pH and plasma levels of the administered drugs were monitored over a dosing interval of 12 h. Results: The overall eradication rates were 45% (intention-to-treat, ITT, 27/60) or 47% (per protocol 27/58); they did not differ (ITT) between omeprazole (50%), lansoprazole (40%) and ranitidine (45%).

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“…Foi demonstrado que a cura de doenças relacionadas com o excesso de ácido está diretamente relacionada com o grau e a duração da supressão ácida e com a duração do tratamento. 14,15 Dessa forma, seu uso é recomendado em diretrizes atuais para o tratamento da doença do refluxo gastroesofágico 13 , para a prevenção de úlcera péptica em pacientes recebendo agentes inflamatórios não esteróides (AINEs), em protocolos de erradicação da Helicobacter pylori, 5 na síndrome de ZollingerEllison, gastrinomas, esofagite e gastrite. 16 A Tabela 1 expõe de maneira sucinta evidências contemporâneas sobre a eficácia do tratamento com inibidores da bomba de prótons.…”

Section: Usosunclassified

<b> INIBIDORES DA BOMBA DE PRÓTONS: REVISÃO E ANÁLISE FARMACOECONÔMICA </b>

2012

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RESUMO:Os inibidores da bomba de prótons (IBPs), são medicamentos que inibem a enzima H + , K + ATPase (ou bomba de prótons) realizando a supressão ácida gástrica. Atualmente, são comercializados seis representantes desta classe: omeprazol, lansoprazol, pantoprazol, rabeprazol, esomeprazol e dexlansoprazol. Um novo IBP, tenatoprazol, está ainda em fase de desenvolvimento. O presente estudo propõese a revisar os estudos disponíveis a fim de expor informações sobre os IBPs e realizar um estudo farmacoeconômico entre dosespadrão desses medicamentos para o tratamento da úlcera péptica gastroduodenal. Evidências atuais sugerem que os IBPs possuem eficácia semelhante no tratamento de várias desordens gástricas e no protocolo de erradicação do Helicobacter pylori. A partir da análise farmacoeconômica ora realizada, constatouse que o lansoprazol apresenta perfil mais favorável.Descritores: Inibidores da bomba de prótons, Estudo farmacoeconômico. Proton Pump Inhibitors: Review and Analysis PharmacoeconomicABSTRACT: The proton pump inhibitors (PPIs) are drugs that inhibit the enzyme H+, K+ATPase (or proton pump), by performing gastric acid suppression. Currently, there are five marketed drugs of this class: omeprazole, lansoprazole, pantoprazole, rabeprazole and esomeprazole. A new PPI, tenatoprazole, is still under development. This study aims to review the available studies in order to reveal information about the PPIs and to perform a pharmacoeconomic study between standard doses of these drugs, employed in the treatment of gastroduodenal peptic ulcer. Current evidence suggests that PPIs have similar efficacy in the treatment of various gastric disorders and in the eradication of Helicobacter pylori. Through the pharmacoeconomic analysis done, it was found that lansoprazole presents a more favorable profile.Descriptors: Proton pump inhibitors; Pharmacoeconomic study.

show abstract

Acid suppression in duodenal ulcer: a meta-analysis to define optimal dosing with antisecretory drugs.

Cited by 255 publications

References 21 publications

Omeprazole is more effective than cimetidine for the relief of all grades of gastro‐oesophageal reflux disease‐associated heartburn, irrespective of the presence or absence of endoscopic oesophagitis

Omeprazole is more effective than cimetidine for the relief of all grades of gastro‐oesophageal reflux disease‐associated heartburn, irrespective of the presence or absence of endoscopic oesophagitis

Age‐dependent eradication of Helicobacter pylori with dual therapy

<b> INIBIDORES DA BOMBA DE PRÓTONS: REVISÃO E ANÁLISE FARMACOECONÔMICA </b>

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