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Efficacy in intra-oesophageal acid suppression may decrease after 2-year continuous treatment with proton pump inhibitors.
Dig Liver Dis. 2007 May; 39(5):415-21.DL

Abstract

BACKGROUND

Long-term intra-oesophageal acid suppression with proton pump inhibitors represents a management option for Barrett's oesophagus and severe reflux oesophagitis, but its stability over time has not been adequately assessed.

AIM

Our aim was to evaluate prospectively the efficacy of proton pump inhibitors in suppressing intra-oesophageal acidity after 2-year continuous treatment.

METHODS

Forty-five patients with Barrett's oesophagus or severe reflux oesophagitis on a proton pump inhibitor regimen (once or twice daily) that normalised the total percentage acid exposure time were re-evaluated by means of 24-h oesophageal pH-monitoring after 2-year of continuous unmodified treatment.

RESULTS

A significant rise in the total percentage acid exposure time was observed at 2-year follow-up (P=0.029), owing to an increased value in 27 (60%) cases (9 on a twice daily regimen), higher than normal in 10 of them (22% of the whole group) (3 on a twice daily regimen). In 18 patients (40%) the total percentage acid exposure time was stable or decreased. Heartburn remained efficiently suppressed in all patients.

CONCLUSIONS

The efficacy of proton pump inhibitors in suppressing intra-oesophageal acidity during continuous treatment may decrease over time, up to abnormal levels of oesophageal acid exposure in a minority of cases. This may occur without heartburn recurrence and with both once and twice daily regimens.

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Authors+Show Affiliations

Frazzoni M
Internal Medicine and Gastroenterology Unit, New S. Agostino Hospital, Viale Giardini 1355, 41100 Modena, Italy. m.frazzoni@ausl.mo.it
Manno M
No affiliation info available
De Micheli E
No affiliation info available
Savarino V
No affiliation info available

MeSH

AdultAgedBarrett EsophagusDrug ToleranceEnzyme InhibitorsEsophagitis, PepticFemaleHumansHydrogen-Ion ConcentrationMaleMiddle AgedProspective StudiesProton Pump InhibitorsTime FactorsTreatment Outcome

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

17379591

Citation

Frazzoni, M, et al. "Efficacy in Intra-oesophageal Acid Suppression May Decrease After 2-year Continuous Treatment With Proton Pump Inhibitors." Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, vol. 39, no. 5, 2007, pp. 415-21.
Frazzoni M, Manno M, De Micheli E, et al. Efficacy in intra-oesophageal acid suppression may decrease after 2-year continuous treatment with proton pump inhibitors. Dig Liver Dis. 2007;39(5):415-21.
Frazzoni, M., Manno, M., De Micheli, E., & Savarino, V. (2007). Efficacy in intra-oesophageal acid suppression may decrease after 2-year continuous treatment with proton pump inhibitors. Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, 39(5), 415-21.
Frazzoni M, et al. Efficacy in Intra-oesophageal Acid Suppression May Decrease After 2-year Continuous Treatment With Proton Pump Inhibitors. Dig Liver Dis. 2007;39(5):415-21. PubMed PMID: 17379591.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy in intra-oesophageal acid suppression may decrease after 2-year continuous treatment with proton pump inhibitors. AU - Frazzoni,M, AU - Manno,M, AU - De Micheli,E, AU - Savarino,V, Y1 - 2007/03/26/ PY - 2006/10/30/received PY - 2007/01/25/revised PY - 2007/01/30/accepted PY - 2007/3/24/pubmed PY - 2007/7/4/medline PY - 2007/3/24/entrez SP - 415 EP - 21 JF - Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver JO - Dig Liver Dis VL - 39 IS - 5 N2 - BACKGROUND: Long-term intra-oesophageal acid suppression with proton pump inhibitors represents a management option for Barrett's oesophagus and severe reflux oesophagitis, but its stability over time has not been adequately assessed. AIM: Our aim was to evaluate prospectively the efficacy of proton pump inhibitors in suppressing intra-oesophageal acidity after 2-year continuous treatment. METHODS: Forty-five patients with Barrett's oesophagus or severe reflux oesophagitis on a proton pump inhibitor regimen (once or twice daily) that normalised the total percentage acid exposure time were re-evaluated by means of 24-h oesophageal pH-monitoring after 2-year of continuous unmodified treatment. RESULTS: A significant rise in the total percentage acid exposure time was observed at 2-year follow-up (P=0.029), owing to an increased value in 27 (60%) cases (9 on a twice daily regimen), higher than normal in 10 of them (22% of the whole group) (3 on a twice daily regimen). In 18 patients (40%) the total percentage acid exposure time was stable or decreased. Heartburn remained efficiently suppressed in all patients. CONCLUSIONS: The efficacy of proton pump inhibitors in suppressing intra-oesophageal acidity during continuous treatment may decrease over time, up to abnormal levels of oesophageal acid exposure in a minority of cases. This may occur without heartburn recurrence and with both once and twice daily regimens. SN - 1590-8658 UR - https://www.unboundmedicine.com/medline/citation/17379591/Efficacy_in_intra_oesophageal_acid_suppression_may_decrease_after_2_year_continuous_treatment_with_proton_pump_inhibitors_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1590-8658(07)00052-7 DB - PRIME DP - Unbound Medicine ER -