Maintenance Treatment for Gastro-Oesophageal Reflux Disease: A Placebo-Controlled Evaluation of 10 Milligrams Omeprazole Once Daily in General Practice

Venables, T. L.; Newland, R. D.; Patel, Ahmed; Hole, J.; Copeman, Michael; Turbitt, M. L.

doi:10.3109/00365529708996509

Cited by 45 publications

(9 citation statements)

References 7 publications

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“…Proton-pump inhibitors can cure a high percentage of patients with GORD, but their interruption is followed by a relapse in most cases after 6-12 months. Nevertheless, between 10% and 49% of those with erosive oesophagitis (11)(12)(13)(14)(15)(16) and from 25% to 56% of those without it remain in remission without drugs (11,(17)(18)(19). On the other hand, in a single study (20) all 14 patients with severe reflux oesophagitis rebelling to H 2 -antagonist treatment showed rapid clinical and endoscopic evidence of recurrent oesophagitis 10 days after suspension of the maintenance treatment with 20-60 mg of omeprazole.…”

Section: Spontaneous Evolution Of Gordmentioning

confidence: 92%

Natural history of gastro‐oesophageal reflux disease: the neglected factor

Bortolotti

2003

Scandinavian Journal of Gastroenterology

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The natural history of gastro-oesophageal reflux disease (GORD) is still a matter for research. The follow-up of GORD patients under placebo and after suspension of the drugs that healed the disease, along with observations of large patient populations treated with, or without, antisecretory drugs for long periods of time, may give some information on the spontaneous evolution of the disease. To single out the outcome of each patient, predictive factors based on demographic, morphologic and pathophysiologic characteristics have been devised, but their reliability is debatable. The reason for their many discrepancies could lie in the fact that, to date, the large majority of investigators have focused their research on the characteristics of gastro-oesophageal reflux and underlying motor activity, and have overlooked the resistance of the oesophageal mucosa. As many studies have shown that the severity of GORD is not proportional to the amount of reflux, we strongly believe that knowledge of the capacity of the mucosa to resist injury and repair the damage is the key to understanding why patients with low reflux may have severe disease, while patients with high reflux may not. Research on the kind and degree of mucosal defects in patients with GORD should receive more attention and because it may help to clarify the laws that govern the GORD evolution.

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Section: Spontaneous Evolution Of Gordmentioning

confidence: 92%

Natural history of gastro‐oesophageal reflux disease: the neglected factor

Bortolotti

2003

Scandinavian Journal of Gastroenterology

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“…Plasma PPI levels and intragastric pH with PPI treatment are highest in the order of PM, hetero-EM, and homo-EM [33,[35][36][37][38]. These CYP2C19 genotype-dependent differences in the pharmacokinetics and pharmacodynamics of PPIs influence the cure rates for GERD [39].…”

Section: Polymorphism Of Ppi Metabolism In Maintenance Therapymentioning

confidence: 94%

Maintenance therapy of gastroesophageal reflux disease

Nagahara

Hojo

Asaoka

et al. 2010

Clin J Gastroenterol

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The aims of treatment of gastroesophageal reflux disease (GERD) are to cure mucosal breaks, control symptoms, and prevent complications (e.g. stricture, Barrett's esophagus, and esophageal adenocarcinoma). Proton pump inhibitors (PPIs) are known to be the best drugs to cure esophagitis; however, a highrecurrence rate of about 80% was described after the completion of initial therapy. Regretfully, not so many physicians perform maintenance therapy in clinical practice. Histamine H2 receptor antagonists have an insufficient effect in maintenance therapy compared with PPIs; therefore, they could be prescribed for mild reflux esophagitis. Several clinical trials have been conducted to investigate the efficacy of continuous PPI administration maintenance therapy for GERD. Among these trials, recent large-scale studies showed that esomeprazole was equal to or superior to other kinds of PPIs. On the other hand, on-demand PPI studies have been conducted, mainly in patients with nonerosive reflux disease or uninvestigated GERD;however, this strategy was less effective than continuous therapy in many studies. Because on-demand therapy is less expensive, it is worth confirming this strategy in further studies. Studies of maintenance therapy with investigations conducted for as long a period as 5 years have described that PPI maintenance therapy could be considered as effective, safe, and well tolerated.

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“…omeprazole, 10 mg) has been shown to achieve good remission rates (73% in one study), but is more likely to fail in patients with oesophagitis. 9 There is increasing support for the on-demand approach as the preferred strategy. [10][11][12] For example, Bardhan et al prospectively enrolled 526 patients and treated them with either an H 2 RA or proton pump inhibitor taken as needed.…”

Section: Choice Of Strategymentioning

confidence: 99%

Overview: initial and long‐term management of gastro‐oesophageal reflux disease

Talley

2003

Aliment Pharmacol Ther

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Summary Initial management of gastro‐oesophageal reflux disease aims to confirm a symptom‐based diagnosis, to relieve symptoms, to reassure the patient as to the treatable nature of reflux disease, and to initiate risk management and healing of oesophagitis. The aims of long‐term management include adequate control of symptoms, prevention of complications, and improvement of quality of life. Management options in terms of use of proton pump inhibitors are either daily therapy (maintenance), intermittent courses of therapy (for example, 4 weeks, then cease and observe), or on‐demand therapy. This overview discusses the advantages and disadvantages of these different strategies for the management of reflux disease.

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Maintenance Treatment for Gastro-Oesophageal Reflux Disease: A Placebo-Controlled Evaluation of 10 Milligrams Omeprazole Once Daily in General Practice

Abstract: This study has shown that 10 mg omeprazole once daily is an effective and well-tolerated treatment strategy in general practice for the long-term management of symptoms of GORD in patients without erosive oesophagitis.

Cited by 45 publications

References 7 publications

Natural history of gastro‐oesophageal reflux disease: the neglected factor

Natural history of gastro‐oesophageal reflux disease: the neglected factor

Maintenance therapy of gastroesophageal reflux disease

Overview: initial and long‐term management of gastro‐oesophageal reflux disease

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