Gastroesophageal reflux disease-related symptom recurrence in patients discontinuing proton pump inhibitors for Bravo wireless esophageal pH monitoring study

Schey, Ron; Alla, Sai P.; Midani, Deena; Parkman, Henry P.

doi:10.1016/j.rgmxen.2017.07.002

Cited by 3 publications

(4 citation statements)

References 15 publications

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“…На сегодняшний день антисекреторная терапия с использованием ИПП является терапией первой линии при индукции и поддержании ремиссии ГЭРБ [12,13,[24][25][26][27]. В рутинной клинической практике нередко бывают ситуации, при которых требуется временная (от одной недели до месяца) отмена ИПП для валидного проведения ряда диагностических мероприятий, что может привести к рецидиву симптоматики у значимой части пациентов [2,18,19,21,22]. Предупреждение рисков рецидива с применением современных групп препаратов является важной задачей современной гастроэнтерологии, так как от его успеха зависит качество жизни пациента -главного интегрального показателя качественной медицинской помощи [2].…”

Section: Discussionunclassified

“…Отмена ИПП может привести к рецидиву симптоматики у значимой части пациентов, что негативно скажется на их качестве жизни. В ряде исследований частота рецидива при отмене ИПП достигала 60-80% [20][21][22]. Использование антацидных препаратов для снижения риска рецидива симптоматики на время отмены ИПП малоэффективно ввиду выраженной краткосрочности их действия.…”

Section: Introductionunclassified

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Reduction of the Risk of Relapse of Symptoms When Using Esophagoprotector in Patients Requiring Temporary Cancellation of Antisecretory Therapy

Kucheryavy¹,

Movtaeva²,

Андреев³

et al. 2021

EPh

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Objective: to evaluate the effectiveness of an esophagoprotector in reducing the risk of recurrent symptoms of gastroesophageal reflux disease (GERD) in patients who requiring temporary cancellation of therapy with proton pump inhibitors (PPIs). Material and methods. For the prospective comparative study there were selectively chose patients who had been taking PPIs for a long time (at least one month) for the underlying disease and who required temporary discontinuation of antisecretory therapy due to objective medical reasons. The study included patients with endoscopically and/or pH-metrically verified GERD, as well as histologically verified Barrett's esophagus. In the process of randomization of patients, two equal groups were formed, depending on the therapy received at the time of PPI withdrawal: group 1 received antacids on demand, group 2 received antacids on demand, as well as the esophagoprotector Alfasoxx at a dose of 10 ml four times a day (after each meal and at night). The follow-up period was two weeks. The patients recorded episodes of heartburn in their personal diaries. Results. The study included 60 patients (28 men and 32 women). The average age of the examined patients was 43.1 ± 5.3 years. By the end of the two-week follow-up period, the frequency of recurrent symptoms in group 1 was 36.7%, while in group 2 it was 13.3%. The use of the esophagoprotector Alfasoxx contributed to the significant regression of the risk of heartburn recurrence (odds ratio 0.2657; 95% confidence interval (CI) 0.07328-0.9637; p = 0.0438) in comparison with the group of patients who received only antacids in the on-demand mode. When analyzing the population of patients who had relapsed symptoms, it was demonstrated that the average number of heartburn episodes in group 1 was 6.18 (95% CI 4,1930-8,1706), and in group 2 – 4.50 (95% CI 0,7121-8,2879). Conclusion. This prospective comparative study demonstrated that the use of the esophagoprotector Alfasoxx helps to reduce the risk of relapse of GERD symptoms in patients requiring temporary cancellation of PPI therapy.

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Section: Discussionunclassified

Section: Introductionunclassified

Reduction of the Risk of Relapse of Symptoms When Using Esophagoprotector in Patients Requiring Temporary Cancellation of Antisecretory Therapy

Kucheryavy¹,

Movtaeva²,

Андреев³

et al. 2021

EPh

View full text Add to dashboard Cite

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“…Initiating or continuing PPI treatment is also a highly attractive capacity-saving approach compared with lifestyle changes such as weight loss or smoking cessation, which are notoriously difficult to sustain long term. Similarly, stopping chronic PPI treatment may result in transient gastric acid hypersecretion above pre-treatment levels, leading to a transient increase in symptom severity [24][25][26]. Such "rebound hypersecretion" is attributable to PPI-induced hypergastrinaemia, which typically resolves after 1-2 weeks [26].…”

Section: Key Drivers Of Ppi Overutilizationmentioning

confidence: 99%

Proton Pump Inhibitors: Rational Use and Use-Reduction – The Windsor Workshop

Kahrilas,

Anastasiou,

Bredenoord

et al. 2024

Dig Dis

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Background: Despite deprescribing initiatives to curb overutilization of proton pump inhibitors (PPIs), achieving meaningful reductions in PPI use is proving a challenge. Summary: An international group of primary care doctors and gastroenterologists examined the literature surrounding PPI use and use-reduction to clarify: (i) what constitutes rational PPI prescribing; (ii) when and in whom PPI use-reduction should be attempted; and (iii) what strategies to use when attempting PPI use-reduction. Key Messages: Before starting a PPI for reflux-like symptoms, patients should be educated on potential causes and alternative approaches including dietary and lifestyle modification, weight loss, and relaxation strategies. When commencing a PPI, patients should understand the reason for treatment, planned duration, and review date. PPI use at hospital discharge should not be continued without a recognized indication for long-term treatment. Long-term PPI therapy should be reviewed at least annually. PPI use-reduction should be based on the lack of a rational indication for long-term PPI use, not concern for PPI-associated adverse events. PPI use-reduction strategies involving switching to on-demand PPI or dose tapering, with rescue therapy for rebound symptoms, are more likely to succeed than abrupt cessation.

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“…Gastroesophageal reflux disease (GERD) is a disease with an extremely high recurrence rate and requires longterm management even in case of the symptoms are mild [1][2][3][4][5][6][7]. Proton pump inhibitors (PPIs) or vonoprazan (VPZ), a potassium-competitive acid blocker (P-CAB) with a stronger effect than PPIs, are the first choice for medication of GERD in Japan [1].…”

Section: Introductionmentioning

confidence: 99%

Examination on Factors Affecting Symptom Change after Drug Withdrawal in Patients with Mild Erosive Gastroesophageal Reflux Disease Undergoing Symptom-Controlled Maintenance Therapy with Acid-Secretion Inhibition Drugs

et al. 2023

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Introduction: In patients with gastroesophageal reflux disease (GERD) on maintenance therapy with acid-suppressive drugs, it is not clear what background factors allow patients to discontinue the drugs. The aims of this study were to examine the relationship of the changes in the frequency and severity of gastrointestinal symptoms after discontinuation of acid-secretion inhibitors for erosive GERD (eGERD) with possible patient background factors and to identify factors that influence these changes. Methods: This is a multicenter, open-label, interventional, exploratory study. eGERD patients with mild mucosal injury whose symptoms were under control and who were on maintenance therapy with acid-suppressive drugs were withdrawn from the drug treatment for 4 weeks. We examined the relationship of patient backgrounds (sex, age, body mass index, alcohol consumption, smoking habits), esophageal hiatal hernia, Helicobacter pylori infection, pepsinogen I and II concentrations and I/II ratios, blood gastrin levels before and after drug discontinuation with total score change in Frequency Scale for the Symptoms of GERD (FSSG). Results: Of the 92 patients whose symptoms could be assessed before and after drug withdrawal, 66 patients (71.7% of the total) had FSSG <8 and no symptom relapse after the withdrawal. Furthermore, patient background factors that may be related to symptom relapse/non-relapse were examined, but no related factors were detected. The maintenance medications before discontinuation in the above 92 patients were a proton pump inhibitor (PPI) and vonoprazan (VPZ, a potassium ion competitive acid blocker). Since PPI and VPZ were administered to about the same number of patients, though incidentally, we additionally examined the relationship between patient background factors and symptom relapse/non-relapse by treatment group. As a result, no relevant background factors were detected in both groups. Although there were no significant differences between the two groups, the severity and frequency of symptom recurrence in the VPZ group tended to be higher than in the PPI group. Conclusions: Consideration of background factors is unlikely to be required in the discontinuation of maintenance therapy for eGERD. There was no significant difference in the extent of disease or frequency of recurrence during the discontinuation period, regardless of whether the drug before discontinuation was a PPI or VPZ.

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Gastroesophageal reflux disease-related symptom recurrence in patients discontinuing proton pump inhibitors for Bravo wireless esophageal pH monitoring study

Cited by 3 publications

References 15 publications

Reduction of the Risk of Relapse of Symptoms When Using Esophagoprotector in Patients Requiring Temporary Cancellation of Antisecretory Therapy

Reduction of the Risk of Relapse of Symptoms When Using Esophagoprotector in Patients Requiring Temporary Cancellation of Antisecretory Therapy

Proton Pump Inhibitors: Rational Use and Use-Reduction – The Windsor Workshop

Examination on Factors Affecting Symptom Change after Drug Withdrawal in Patients with Mild Erosive Gastroesophageal Reflux Disease Undergoing Symptom-Controlled Maintenance Therapy with Acid-Secretion Inhibition Drugs

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