Journal of clinical gastroenterology · 2004
On-demand PPI requirements in patients with endoscopy-negative GERD.
Клиническое исследованиеСтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Juul-Hansen Paul, Rydning Andreas
Аннотация
GOALS: To evaluate the need for on-demand treatment with proton pump inhibitor in patients with endoscopy-negative GERD.
BACKGROUND: Studies indicate that on-demand therapy is suitable for patients without mucosal disease, but the need for PPI in a monotherapy situation is not known.
STUDY: Forty-one patients with heartburn and/or acid reflux of more than 3 months duration participated in the study. All were endoscopy-negative and had responded positive to a test with lansoprazole 60 mg x 1 for 7 days. Twenty-four hour pH monitoring was attempted in all, but failed in 4. Twenty-eight had pH <4 more than 4% of the time, 9 had less. During a 3-month period, the patients were allowed to take 1 capsule 30 mg lansoprazole on-demand, maximum 2 capsules a day. The remaining capsules were counted monthly.
RESULTS: In the 3-month period, the median mean daily consumption was 1.06 capsule (95% CI: 0072-1.09). No significant difference was found between those with normal or abnormal 24-hour pH-metry. Sixty-three percent used 6 or more capsules a week.
CONCLUSION: Patients with longstanding negative-endoscopy reflux disease, whether abnormal or normal 24-hour pH-metry, have symptoms that demand effective therapy. Using PPI on-demand as monotherapy, most patients will need 1 capsule per day.
BACKGROUND: Studies indicate that on-demand therapy is suitable for patients without mucosal disease, but the need for PPI in a monotherapy situation is not known.
STUDY: Forty-one patients with heartburn and/or acid reflux of more than 3 months duration participated in the study. All were endoscopy-negative and had responded positive to a test with lansoprazole 60 mg x 1 for 7 days. Twenty-four hour pH monitoring was attempted in all, but failed in 4. Twenty-eight had pH <4 more than 4% of the time, 9 had less. During a 3-month period, the patients were allowed to take 1 capsule 30 mg lansoprazole on-demand, maximum 2 capsules a day. The remaining capsules were counted monthly.
RESULTS: In the 3-month period, the median mean daily consumption was 1.06 capsule (95% CI: 0072-1.09). No significant difference was found between those with normal or abnormal 24-hour pH-metry. Sixty-three percent used 6 or more capsules a week.
CONCLUSION: Patients with longstanding negative-endoscopy reflux disease, whether abnormal or normal 24-hour pH-metry, have symptoms that demand effective therapy. Using PPI on-demand as monotherapy, most patients will need 1 capsule per day.
Предметные рубрики MeSH
2-PyridinylmethylsulfinylbenzimidazolesAdultAgedAnti-Ulcer AgentsCapsulesDrug Administration ScheduleEndoscopy, GastrointestinalFemaleGastroesophageal RefluxHeartburnHumansHydrogen-Ion ConcentrationLansoprazoleMaleMiddle AgedMonitoring, PhysiologicOmeprazoleProspective StudiesProton Pump InhibitorsTreatment Outcome