Observational comparative trial of the efficacy of proton pump inhibitors versus histamine‐2 receptor antagonists for uninvestigated dyspepsia

Nagahara, Akihito; Asaoka, Daisuke; Hojo, Mariko; Oguro, Masako; Shimada, Yuji; Ishikawa, Dai; Osada, Taro; Kawabe, Masato; Yoshizawa, Takashi; Otaka, Michiro; Watanabe, Sumio

doi:10.1111/j.1440-1746.2009.06218.x

Cited by 13 publications

(14 citation statements)

References 33 publications

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“…[11] The mFSSGERD scale used in this study is also a validated scale and has been employed successfully to assess different symptom groups in earlier studies. [12] Further, both physical and mental dimensions of QoL were measured and compared between the groups using a standardized instrument. [13]…”

Section: Discussionmentioning

confidence: 99%

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Randomized controlled trial of effectiveness of lafutidine versus pantoprazole in uninvestigated dyspepsia

et al. 2014

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Objectives:Lafutidine is a new H2-blocker in India claimed to be more potent and effective than existing H2-blockers. Proton pump inhibitors (PPIs), by virtue of their mechanism of action, have greater efficacy than H2-blockers in gastric acid suppression. However, clinical trials comparing H2-blockers directly with PPIs are limited. We carried out a head-to-head comparison of the effectiveness of lafutidine versus the PPI pantoprazole in uninvestigated dyspepsia [CTRI/2013/12/004261].Materials and Methods:A prospective, open label, randomized, controlled trial was conducted in a tertiary care hospital. Ambulatory adult patients with dyspepsia, not yet subjected to endoscopy, were recruited if they had at least moderately severe symptoms, defined as a score of ≥ 4 on a 7-point Global Overall Symptom (GOS) Scale. Those with alarm features or significant comorbidity were excluded. Subjects received either once daily lafutidine 10 mg or pantoprazole 40 mg, orally, for 8 weeks. Reflux, dysmotility and pain scores were assessed by Modified Frequency Scale for the Symptoms of Gastroesophageal Reflux Disease (mFSSGERD), and quality of life (QoL) by SF-8 scale. The latter had physical and mental components summarized by physical component summary score (PCS) and a mental component summary score (MCS).Results:Of 122 patients enrolled, data of 57 on lafutidine and 60 on pantoprazole were analyzed. At 4 weeks, proportion of subjects responding (GOS score ≤ 2) in the two arms (lafutidine 45.61% vs. pantoprazole 48.33%, P = 0.854) or showing symptom resolution (GOS score ≤ 1) (lafutidine 12.28% vs. pantoprazole 5.00%; P = 0.197) were comparable. Similarly at 8 weeks, both responder (lafutidine 52.63% vs. pantoprazole 56.67%; P = 0.712) and symptom resolution proportions (lafutidine 33.33% vs. pantoprazole 30%; P = 0.843) were comparable. Total score on mFSSGERD scale, as well as all its three component scores, and PCS and MCS scores on QoL SF-8 scale showed improvement but no statistically significant difference between the two arms. Tolerability of both drugs was excellent.Conclusions:Lafutidine is well-tolerated and there is no clinically worthwhile difference between the two drugs in the empirical treatment of uninvestigated dyspepsia.

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Section: Discussionmentioning

confidence: 99%

“…Secondary efficacy measures used were the Modified Frequency Scale for the Symptoms of Gastroesophageal Reflux Disease (mFSSGERD)[12] and Quality of Life (QOL) as measured by short form-8 (SF-8) questionnaire scores. [13] The mFSSGERD scale provided total score (Q-T), reflux score (Q-R), dyspepsia score (Q-D) and pain score (Q-P).…”

Section: Methodsmentioning

confidence: 99%

Randomized controlled trial of effectiveness of lafutidine versus pantoprazole in uninvestigated dyspepsia

et al. 2014

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“…Although the patient number of this study is a few, ratio of GERD might be more frequent than expected among smokers. Intervention studies with patients with GERD symptoms, RS and DS are ameliorating associated with PPI administration [17,18]. Consequently, the FSSG is useful for evaluation of GERD symptoms and therapeutic effect.…”

Section: Discussionmentioning

confidence: 99%

“…ssary to diagnose RE, however, general p deal with GERD patients. Therefore, some study was focused on uninvestigated GERD, which is diagnosed by symptoms [17,19]. Indeed, GERD management guideline which was published by The Japanese Society of Gastroenterology described that initial therapy could be performed without endoscopy for patient with GERD symptoms [20].…”

Section: Discussionmentioning

confidence: 99%

Quit smoking improves gastroesophageal reflux symptoms and quality of life

Nakajima¹,

Nagahara²,

Kurosawa³

et al. 2011

Health

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Background: Smoking is considered to be risk factors of gastroesophageal reflux disease (GERD). The present study aimed to reveal whether quit smoking improves GERD symptoms and QOL of patients. Methods: In this prospective study, 33 patients who participated in a 12-week quit smoking program filled out the Frequency Scale for the Symptoms of GERD (FSSG) questionnaire, and SF8 QOL questionnaire. Patients filled out the questionnaires at baseline and during the program at 2 weeks, 4 weeks, 8 weeks and 12 weeks. In the FSSG, the responses were scored and the reflux score (RS), dysmotility score (DS) and total score (TS) were calculated. Results: There were 22 males and 11 females. Their mean age was 54.8 ± 13.0 (mean ± SD) yr, BMI was 22.9 ± 4.0, and duration of smoking was 33.5 ± 12.5 years. Ten patients belonged to GERD subgroup (baselineFSSGscore ≥ 8). All patients were successful at quit smoking. Scores of TS/RS/DS are 8.6 ± 1.8 (mean ± SE)/4.2 ± 0.9/4.5 ± 0.9 at baseline, 4

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“…omeprazole, lansoprazole, esomeprazole), another class of acid reducers with long-lasting reduction of gastric acid production [18,19], are more effective than H2RAs in treating acid-related gastrointestinal diseases such as gastrooesophageal reflux disease [20][21][22][23], ulcer [21,24], dyspepsia [25] and Zollinger-Ellison syndrome [26]; however, H2RAs are still widely used in the treatment of acid-related gastrointestinal diseases. One reason for this is that proton pump inhibitors therapy is more expensive and less cost-effective, at least in certain cases of acid-related gastrointestinal diseases, compared with H2RAs [10,27].…”

mentioning

confidence: 99%

Histamine‐2 Receptor Antagonists and Semen Quality

Banihani

2015

Basic Clin Pharma Tox

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Histamine-2 receptor antagonists are a class of drugs used to treat the acid-related gastrointestinal diseases such as ulcer and gastro-oesophageal reflux disease. Although such drugs, especially ranitidine and famotidine, are still widely used, their effects on semen quality, and hence on male infertility, is still unclear. This MiniReview systematically addresses and summarizes the effect of histamine-2 receptor antagonists (cimetidine, ranitidine, nizatidine and famotidine) on semen quality, particularly, on sperm function. Cimetidine appears to have adverse effects on semen quality. While the effects of ranitidine and nizatidine on semen quality are still controversial, famotidine does not appear to change semen quality. Therefore, additional studies will be required to clarify whether histamine-2 receptor-independent effects of these drugs play a role in semen quality as well as further clinical studies including direct comparison of the histamine-2 receptor antagonists.The histamine-2 (H2) receptors are widely expressed and can be found in gastric mucosal cells, heart, central nervous system, immune cells, smooth muscles of the airway, vasculature and uterus [1]. They are positively coupled to adenylate cyclase via Gs alpha subunit [2,3]. The activation of histamine-2 receptors by histamine alters the activity of Gs and therefore enhances the intracellular cyclic AMP (cAMP) production [3]. cAMP activates protein kinase A, which phosphorylates the cytoskeletal proteins, leading to the transport of the H + /K + ATPase (proton pump) from the cytoplasm to the plasma membrane of parietal cells [3,4]. H2 receptor activation stimulates hydrochloric acid secretion from the acidsecreting parietal cells of the gastric mucosa, leads to smooth muscle relaxation in the vasculature and airways, increases cardiac rate and contractility, and mediates some of the immunomodulatory effects of histamine [1]. Histamine-2 receptor antagonists (H2RAs), also called H 2 -blockers (e.g. cimetidine, ranitidine, nizatidine and famotidine), are the medications used to reduce the amount of hydrochloric acid produced by the stomach [5][6][7]. Mechanistically, these drugs are competitive antagonists of histamine-2 receptors [6,7]. In view of that, H2RAs are used to treat the acid-related gastrointestinal diseases such as gastrooesophageal reflux disease [8,9], dyspepsia [10-12], Zollinger-Ellison syndrome [13,14] and ulcer [15][16][17].Various studies have shown that proton pump inhibitors (e.g. omeprazole, lansoprazole, esomeprazole), another class of acid reducers with long-lasting reduction of gastric acid production [18,19], are more effective than H2RAs in treating acid-related gastrointestinal diseases such as gastrooesophageal reflux disease [20][21][22][23], ulcer [21,24], dyspepsia [25] and Zollinger-Ellison syndrome [26]; however, H2RAs are still widely used in the treatment of acid-related gastrointestinal diseases. One reason for this is that proton pump inhibitors therapy is more expensive and less cost-effective, ...

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Observational comparative trial of the efficacy of proton pump inhibitors versus histamine‐2 receptor antagonists for uninvestigated dyspepsia

Abstract: Both PPI and H2RA have a positive effect on P-S, but H(2)RA therapy is limited for R-S and D-S, whereas PPI therapy is generally effective. Therefore, careful prescription based on symptoms is important.

Cited by 13 publications

References 33 publications

Randomized controlled trial of effectiveness of lafutidine versus pantoprazole in uninvestigated dyspepsia

Randomized controlled trial of effectiveness of lafutidine versus pantoprazole in uninvestigated dyspepsia

Quit smoking improves gastroesophageal reflux symptoms and quality of life

Histamine‐2 Receptor Antagonists and Semen Quality

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