Low‐dose intravenous pantoprazole for optimal inhibition of gastric acid in Korean patients

Oh, Jung Hwan; Choi, Myung‐Gyu; Dong, Maoqing; Park, Jae Myung; Paik, Chang Nyol; Cho, Yu-Kyung; Jeong, Jeong-Jo; Lee, In-Seok; Kim, Sang Woo; Han, Sok-Won; Choi, Kyu-Yong; Chung, In‐Sik

doi:10.1111/j.1440-1746.2007.05059.x

Cited by 23 publications

(19 citation statements)

References 26 publications

(40 reference statements)

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“…Thus, in our study, patients in the intermittent pantoprazole infusion group received a 2.5 times less daily pantoprazole dose than the continuous infusion group. A Korean study has shown that a low dose (40 mg twice daily) of pantoprazole can maintain an intragastric pH of >6 [16]. In our study, intermittent and continuous pantoprazole infusion treatment had a similar effect on reducing rebleeding, the necessity for rescue therapy, duration of hospital stay and need for blood transfusion.…”

Section: Discussionsupporting

confidence: 57%

“…Also, the required dose of PPIs may differ according to ethnic groups to achieve an optimal level of acid suppression in bleeding peptic ulcers [24]. It has been speculated that diverse responses to PPIs may be due to a smaller parietal cell mass and more frequent CYP2C19 polymorphism in Asians in comparison to Caucasians [16, 25]. A systematic review and meta-analysis has enhanced the efficacy of PPI therapy for peptic ulcer bleeding in Asia – a post-hoc analysis from the Cochrane Collaboration [24].…”

Section: Discussionmentioning

confidence: 99%

“…In Indian and Iranian studies, oral omeprazole alone 80 mg/day was able to reduce rebleeding rates [13,14,15]. In a recent study, it has been reported that low-dose intravenous pantoprazole provides optimal inhibition of gastric acid in Korean patients [16]. Hung et al [17] have also recently reported that either infusion or bolus pantoprazole treatment decreases rebleeding after endoscopic treatment for bleeding peptic ulcer in Chinese patients.…”

Section: Introductionmentioning

confidence: 97%

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Intermittent versus Continuous Pantoprazole Infusion in Peptic Ulcer Bleeding: A Prospective Randomized Study

et al. 2008

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Background and Aim: Rebleeding has remained the most important determinant of poor prognosis in peptic ulcer bleeding. Gastric acid plays an important role in the pathogenesis of rebleeding. We aimed to compare the efficiency of intermittent and continuous pantoprazole infusion treatment on peptic ulcer rebleeding after endoscopic therapy. Materials and Method: In this prospective study, patients with active peptic ulcer bleeding or non-bleeding visible vessel were treated initially with endoscopic therapy. They were randomized to receive intermittent or continuous intravenous pantoprazole treatment. Rebleeding rate, duration of hospital stay, need for total blood transfusion and need for urgent surgery were compared among both groups. Results: Rebleeding rate (6.1 vs. 8.3%), duration of hospital stay (4.17 vs. 4.41), need for total blood transfusion (2.18 vs. 2.59) and need for urgent surgery (4.1 vs. 4.2%) were similar in intermittent and continuous pantoprazole infusion therapy groups, respectively. There was no bleeding-related death in either group. Conclusion: In patients with peptic ulcer bleeding, intermittent and continuous pantoprazole infusion after successful endoscopic therapy have comparable outcomes in reducing rebleeding. Both have similar effects on hospital stay, need for blood transfusion and urgent surgery. Intermittent administration has application and cost advantages over continuous infusion.

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Section: Discussionsupporting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

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Intermittent versus Continuous Pantoprazole Infusion in Peptic Ulcer Bleeding: A Prospective Randomized Study

et al. 2008

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“…It is expected that H. pylori-positive patients would have a more severe degree of chronic atrophic gastritis and/or intestinal metaplasia, and the reduction of parietal cell mass caused by these seems to be one reason for these differences. However, this study did not measure the degree of changes in mucosa through Contrary to our expectations, there was no difference in pH according to CYP2C19 genotyping, which confirms previous reports that significant differences are only found at 40 mg per day (20). Our study reaffirmed that these differences are not found at 80 mg.…”

Section: Discussionsupporting

confidence: 77%

Effective administration method of intravenous proton pump inhibitor: A novel testing using a BRAVO catheterless pH monitoring system

Kim

Park²,

Park³

et al. 2011

Turk J Gastroenterol

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“…Rapid ulcer healing through clot stabilization at an elevated intragastric pH is required. Inhibition of gastric acid to maintain a neutral pH could stabilize blood clots and prevent recurrent bleeding [17,18], because the blood coagulation system and platelet aggregation are sensitive to changes in intragastric pH. PPI and H 2 RA are classical acid-suppressing agents, and PPI is no doubt the stronger acid inhibitor for the treatment of gastric ulcer.…”

Section: Discussionmentioning

confidence: 99%

Proton Pump Inhibitors versus Histamine-2-Receptor Antagonists for the Management of Iatrogenic Gastric Ulcer after Endoscopic Mucosal Resection or Endoscopic Submucosal Dissection: A Meta-Analysis of Randomized Trials

Yang

Liu

et al. 2011

Digestion

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Background/Aims: Both proton pump inhibitor (PPI) and histamine-2-receptor antagonist (H₂RA) are considered to be effective for the treatment of iatrogenic gastric ulcer after endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD). We aimed to systematically evaluate the evidence comparing PPI and H₂RA for iatrogenic ulcer. Methods: Data from PubMed, Cochrane Library and Google Scholar were searched to identify eligible randomized trials. Outcome measures were delayed bleeding, epigastric pain and ulcer healing. Results: Six full-text studies were identified including a total of 522 patients. Pooled data suggested a significantly lower bleeding rate in the PPI group than in the H₂RA group (odds ratio (OR) 0.49, 95% confidence interval (CI) 0.25-0.95). Subgroup analysis showed PPI was more effective in the prevention of bleeding than H₂RA for ESD-induced ulcer (OR 0.41, 95% CI 0.20-0.85) and 8-week duration of medication (OR 0.36, 95% CI 0.17-0.76). There were no differences in the incidence of epigastric pain (OR 0.90, 95% CI 0.53-1.51) and ulcer healing rate after endoscopic therapies between both groups. Conclusion: This meta-analysis shows PPI is superior to H₂RA for the prevention of delayed bleeding without different effectiveness in the reduction of epigastric pain and in the promotion of ulcer healing after EMR or ESD.

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Low‐dose intravenous pantoprazole for optimal inhibition of gastric acid in Korean patients

Abstract: A 40 mg b.i.d. dose of pantoprazole is sufficient to maintain pH > 6.0 in Korean patients, except for patients with extensive metabolizing CYP2C19 genotypes.

Cited by 23 publications

References 26 publications

Intermittent versus Continuous Pantoprazole Infusion in Peptic Ulcer Bleeding: A Prospective Randomized Study

Intermittent versus Continuous Pantoprazole Infusion in Peptic Ulcer Bleeding: A Prospective Randomized Study

Effective administration method of intravenous proton pump inhibitor: A novel testing using a BRAVO catheterless pH monitoring system

Proton Pump Inhibitors versus Histamine-2-Receptor Antagonists for the Management of Iatrogenic Gastric Ulcer after Endoscopic Mucosal Resection or Endoscopic Submucosal Dissection: A Meta-Analysis of Randomized Trials

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