M1033 Nighttime Symptoms and Sleep Impairment Among Patients with Gastro-Esophageal Reflux Disease (GERD) Receiving Prescription (Rx) Proton Pump Inhibitors (PPIs)

Chey, William D.; Mody, Reema; Chen, Lei; Kothari, Smita; Persson, Bjorn; Wu, Eric; Lu, Mei

doi:10.1016/s0016-5085(08)61509-7

Cited by 7 publications

(12 citation statements)

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“…Another nationwide survey demonstrated that over 80% of adults taking PPIs for GERD reported nocturnal symptoms during the previous month, and 23.4% described their symptoms as severe or very severe. 33 Almost 22% of responders were on PPI twice daily, and 42% supplemented the prescribed PPI with an over-the-counter PPI, H2RA, or antacid. 33 Of those patients on PPI twice daily, almost 40% stated that they doubled the dose due to inadequate control of nighttime GERD-related symptoms.…”

Section: Nighttime Heartburnmentioning

confidence: 99%

“…33 Almost 22% of responders were on PPI twice daily, and 42% supplemented the prescribed PPI with an over-the-counter PPI, H2RA, or antacid. 33 Of those patients on PPI twice daily, almost 40% stated that they doubled the dose due to inadequate control of nighttime GERD-related symptoms. 34 Several studies have also shown that the response rate of PPI once daily for nighttime heartburn is significantly lower (up to 53%) than the response rate for daytime heartburn (up to 66%).…”

Section: Nighttime Heartburnmentioning

confidence: 99%

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Unmet Needs in the Treatment of Gastroesophageal Reflux Disease

Dickman

Maradey–Romero

Gingold‐Belfer

et al. 2015

J Neurogastroenterol Motil

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Gastroesophageal reflux disease (GERD) is a highly prevalent gastrointestinal disorder. Proton pump inhibitors have profoundly revolutionized the treatment of GERD. However, several areas of unmet need persist despite marked improvements in the therapeutic management of GERD. These include the advanced grades of erosive esophagitis, nonerosive reflux disease, maintenance treatment of erosive esophagitis, refractory GERD, postprandial heartburn, atypical and extraesophageal manifestations of GERD, Barrett's esophagus, chronic protein pump inhibitor treatment, and post-bariatric surgery GERD. Consequently, any future development of novel therapeutic modalities for GERD (medical, endoscopic, or surgical), would likely focus on the aforementioned areas of unmet need.

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Section: Nighttime Heartburnmentioning

confidence: 99%

Section: Nighttime Heartburnmentioning

confidence: 99%

Unmet Needs in the Treatment of Gastroesophageal Reflux Disease

Dickman

Maradey–Romero

Gingold‐Belfer

et al. 2015

J Neurogastroenterol Motil

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“…Another recent survey from a large US community health plan found that over 80% of GORD sufferers experienced residual nighttime symptoms despite daily proton pump inhibitor (PPI) therapy. Approximately, 50% of patients with nighttime symptoms reported disturbed sleep, the most common problems being ‘waking up at night’ (66.2%), ‘trouble falling asleep again after waking up’ (52.6%) and ‘trouble falling asleep’ (37.2%) 8 . It is important to note that the majority of the available data address the prevalence and clinical impact of disturbed sleep in patients with nighttime GORD symptoms.…”

Section: Prevalence Of Sleep Disorders In Gastro‐oesophageal Reflux Dmentioning

confidence: 99%

Sleep disorders and gastrointestinal symptoms: chicken, egg or vicious cycle?

Maneerattanaporn

Chey

2009

Neurogastroenterology Motil

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“…Similarly, Chey et al [21] found that a higher proportion of those with nighttime symptoms took prescription PPIs twice daily (24.3% vs 12.7%, P = 0.008) and were more likely to supplement their PPIs with other GERD medications (45.5% vs 27.9%, P = 0.003).…”

Section: Unmet Needs In the Patient With Gerdmentioning

confidence: 93%

Novel Approaches to Inhibition of Gastric Acid Secretion

Sachs

Shin

Hunt

2010

Curr Gastroenterol Rep

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The gastric H,K-adenosine triphosphatase (ATPase) is the primary target for treatment of acid-related diseases. Proton pump inhibitors (PPIs) are weak bases composed of two moieties, a substituted pyridine with a primary pKa of about 4.0 that allows selective accumulation in the secretory canaliculus of the parietal cell, and a benzimidazole with a second pKa of about 1.0. Protonation of this benzimidazole activates these prodrugs, converting them to sulfenic acids and/or sulfenamides that react covalently with one or more cysteines accessible from the luminal surface of the ATPase. The maximal pharmacodynamic effect of PPIs as a group relies on cyclic adenosine monophosphate–driven H,K-ATPase translocation from the cytoplasm to the canalicular membrane of the parietal cell. At present, this effect can only be achieved with protein meal stimulation. Because of covalent binding, inhibitory effects last much longer than their plasma half-life. However, the short dwell-time of the drug in the blood and the requirement for acid activation impair their efficacy in acid suppression, particularly at night. All PPIs give excellent healing of peptic ulcer and produce good, but less than satisfactory, results in reflux esophagitis. PPIs combined with antibiotics eradicate Helicobacter pylori, but success has fallen to less than 80%. Longer dwell-time PPIs promise to improve acid suppression and hence clinical outcome. Potassium-competitive acid blockers (P-CABs) are another class of ATPase inhibitors, and at least one is in development. The P-CAB under development has a long duration of action even though its binding is not covalent. PPIs with a longer dwell time or P-CABs with long duration promise to address unmet clinical needs arising from an inability to inhibit nighttime acid secretion, with continued symptoms, delayed healing, and growth suppression of H. pylori reducing susceptibility to clarithromycin and amoxicillin. Thus, novel and more effective suppression of acid secretion would benefit those who suffer from acid-related morbidity, continuing esophageal damage and pain, nonsteroidal anti-inflammatory drug–induced ulcers, and nonresponders to H. pylori eradication.

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M1033 Nighttime Symptoms and Sleep Impairment Among Patients with Gastro-Esophageal Reflux Disease (GERD) Receiving Prescription (Rx) Proton Pump Inhibitors (PPIs)

Cited by 7 publications

References 0 publications

Unmet Needs in the Treatment of Gastroesophageal Reflux Disease

Unmet Needs in the Treatment of Gastroesophageal Reflux Disease

Sleep disorders and gastrointestinal symptoms: chicken, egg or vicious cycle?

Novel Approaches to Inhibition of Gastric Acid Secretion

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