Helicobacter pylori infection prevents the occurrence of the tolerance phenomenon of histamine H2 receptor antagonists

Abstract

SUMMARY Background:The attenuated anti-secretory activity of H2 receptor antagonists (H2RA) during continuous administration is referred to as the tolerance phenomenon. However, it is not clarified whether Helicobacter pylori infection affects the occurrence of tolerance to H2RA. It is also not clarified whether the tolerance phenomenon occurs to a new H2RA, lafutidine. Aim: To investigate the occurrence of the tolerance phenomenon in subjects with and without H. pylori infection during the continuous administration of lafutidine and famotidine. Subjects and Methods: Subjects were 20 healthy male volunteers (seven H. pylori positive and 13 H. pylori

Which Has Superior Acid-Suppressive Effect, 10 Mg Omeprazole Once Daily or 20 Mg Famotidine Twice Daily? Effects of Single or Repeated Administration in Japanese Helicobacter Pylori-Negative CYP2C19 Extensive Metabolizers

“…This phenomenon develops within the first month of repeated administration of H 2 -RAs; however, the acid-suppressive effect remains constant between the first and fifth months of repeated administration [54]. This phenomenon is observed only in H. pylori-negative subjects [55]; therefore, this may be the reason why H 2 -RAs are as effective as PPIs in peptic ulcer patients, almost all of whom H. pylori-infection is positive, but when H 2 -RAs are used for initial and maintenance therapies for GERD patients, most of whom are H. pylori-infection negative, these therapies often end in failure.…”

Review: Causes of, and therapeutic approaches for, proton pump inhibitor-resistant gastroesophageal reflux disease in Asia

“…The acid-secretion-suppressing effects of H2RAs show a tolerance phenomenon, thus after 2 weeks of administration the effects fade remarkably in uninfected cases. In H. pyloriinfected cases, H2RAs show little tolerance phenomenon and the acid-suppressing effects last longer [Fujisawa et al 2004]. Approximately 70% of patients with high-grade reflux esophagitis are reported to be negative for H. pylori infection, even in Japan where the infection rate is higher than in Western countries.…”

“…tachyphylaxis) has been found with all types of H2RAs. Thus, these drugs are generally used to inhibit acid secretion for a short period, especially in patients not infected by Helicobacter pylori [Fujisawa et al 2004]. Acid inhibitors are effective for complications and unpleasant symptoms associated with GERD; however, they do not treat pathophysiological abnormalities that cause pathological gastroesophageal reflux.…”

Heartburn issues burnt out?

“…Another reason for the inefficient control exercised by H2RAs after the eradication of H. pylori may be the development of tolerance to these agents after the eradication of H. pylori. 16 Thus, eradication therapy may have an impact on drug choice, rendering PPI as the first choice for patients with mild-grade RE.…”