The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지
DOI QR코드

DOI QR Code

Proton Pump Inhibitor for Gastroesophageal Reflux Disease: Intelligent Prescription

위식도역류 질환에서 양성자 펌프 억제제의 장기처방

  • Jo, Yun Ju (Department of Internal Medicine, Eulji University School of Medicine)
  • 조윤주 (을지대학교 의과대학 내과학교실)
  • Published : 2013.02.01
⟨ Previous Next ⟩

Abstract

Gastroesophageal reflux disease (GERD) has a chronicity and its symptoms wax and wane by proton pump inhibitor (PPI) therapy. Chronic consumption of PPI in the patients with GERD is common, and we can cope with a PPI failure or refractory GERD. Therefore, we review various alternative modalities for chronic PPI treatment and an approach for refractory GERD. PPI has a potential for side effects. Many studies have been published the side effects of long-term PPI using. Mostly clinical level of evidence is weak and the absolute risk is low, however we may discuss the patients who need long-term PPI therapy about the controversial side effects, and manage those appropriately.

Keywords

References

  1. Vakil N, van Zanten SV, Kahrilas P, Dent J, Jones R; Global Consensus Group. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol 2006;101:1900-1920. https://doi.org/10.1111/j.1572-0241.2006.00630.x
  2. Kahrilas PJ, Shaheen NJ, Vaezi MF, et al. American Gastroenterological Association Medical Position Statement on the management of gastroesophageal reflux disease. Gastroenterology 2008;135:1383-1391. https://doi.org/10.1053/j.gastro.2008.08.045
  3. Fock KM, Talley NJ, Fass R, et al. Asia-Pacific consensus on the management of gastroesophageal reflux disease: update. J Gastroenterol Hepatol 2008;23:8-22.
  4. Jung HK, Hong SJ, Jo Y, et al. Updated guidelines 2012 for gastroesophageal reflux disease. Korean J Gastroenterol 2012;60:195-218. https://doi.org/10.4166/kjg.2012.60.4.195
  5. Yang YX, Metz DC. Safety of proton pump inhibitor exposure. Gastroenterology 2010;139:1115-1127. https://doi.org/10.1053/j.gastro.2010.08.023
  6. Chung SJ, Kim SG, Jung HC, Song IS, Kim JS. Clinical practice patterns of gastroenterologists for initial and maintenance therapy in gastroesophageal reflux disease: a nationwide online survey in Korea. Korean J Gastroenterol 2009;54:364-370. https://doi.org/10.4166/kjg.2009.54.6.364
  7. Sharma VK, Leontiadis GI, Howden CW. Meta-analysis of randomized controlled trials comparing standard clinical doses of omeprazole and lansoprazole in erosive oesophagitis. Aliment Pharmacol Ther 2001;15:227-231. https://doi.org/10.1046/j.1365-2036.2001.00904.x
  8. Sjostedt S, Befrits R, Sylvan A, et al. Daily treatment with esomeprazole is superior to that taken on-demand for maintenance of healed erosive oesophagitis. Aliment Pharmacol Ther 2005;22:183-191. https://doi.org/10.1111/j.1365-2036.2005.02553.x
  9. Labenz J, Armstrong D, Lauritsen K, et al. A randomized comparative study of esomeprazole 40 mg versus pantoprazole 40 mg for healing erosive oesophagitis: the EXPO Study. Aliment Pharmacol Ther 2005;21:739-746. https://doi.org/10.1111/j.1365-2036.2005.02368.x
  10. Bardhan KD. Intermittent and on-demand use of proton pump inhibitors in the management of symptomatic gastroesophageal reflux disease. Am J Gastroenterol 2003;98(3 Suppl): S40-S48. https://doi.org/10.1111/j.1572-0241.2003.07852.x
  11. Bardhan KD, Muller-Lissner S, Bigard MA, et al. Symptomatic gastro-oesophageal reflux disease: double blind controlled study of intermittent treatment with omeprazole or ranitidine. The European Study Group. BMJ 1999;318: 502-507. https://doi.org/10.1136/bmj.318.7182.502
  12. Fass R, Delemos B, Nazareno L, Kao R, Xiang J, Lu Y. Clinical trial: maintenance intermittent therapy with rabeprazole 20 mg in patients with symptomatic gastrooesophageal reflux disease-a double-blind, placebo-controlled, randomized study. Aliment Pharmacol Ther 2010;31:950-960.
  13. Zacny J, Zamakhshary M, Sketris I, Veldhuyzen van Zanten S. Systematic review: the efficacy of intermittent and on-demand therapy with histamine H2-receptor antagonists or proton pump inhibitors for gastro-oesophageal reflux disease patients. Aliment Pharmacol Ther 2005;21:1299-1312. https://doi.org/10.1111/j.1365-2036.2005.02490.x
  14. Bytzer P, Blum A, De Herdt D, Dubois D; Trial Investigators. Six-month trial of on-demand rabeprazole 10 mg maintains symptom relief in patients with non-erosive reflux disease. Aliment Pharmacol Ther 2004;20:181-188. https://doi.org/10.1111/j.1365-2036.2004.01999.x
  15. Scholten T, Dekkers CP, Schutze K, Korner T, Bohuschke M, Gatz G. On-demand therapy with pantoprazole 20 mg as effective long-term management of reflux disease in patients with mild GERD: the ORION Trial. Digestion 2005;72:76-85. https://doi.org/10.1159/000087661
  16. Bour B, Staub JL, Chousterman M, et al. Long-term treatment of gastro-oesophageal reflux disease patients with frequent symptomatic relapses using rabeprazole: on-demand treatment compared with continuous treatment. Aliment Pharmacol Ther 2005;21:805-812. https://doi.org/10.1111/j.1365-2036.2005.02413.x
  17. Vasiliadis KV, Viazis N, Vlachogiannakos J, et al. Efficacy of three different dosages of esomeprazole in the long-term management of reflux disease: a prospective, randomized study, using the wireless Bravo pH system. Am J Gastroenterol 2010;105:308-313. https://doi.org/10.1038/ajg.2009.556
  18. Peters MJ, Mukhtar A, Yunus RM, et al. Meta-analysis of randomized clinical trials comparing open and laparoscopic anti-reflux surgery. Am J Gastroenterol 2009;104:1548-1561. https://doi.org/10.1038/ajg.2009.176
  19. Lundell L, Miettinen P, Myrvold HE, et al. Comparison of outcomes twelve years after antireflux surgery or omeprazole maintenance therapy for reflux esophagitis. Clin Gastroenterol Hepatol 2009;7:1292-1298. https://doi.org/10.1016/j.cgh.2009.05.021
  20. Lee SK, Kim EK. Laparoscopic Nissen fundoplication in Korean patients with gastroesophageal reflux disease. Yonsei Med J 2009;50:89-94. https://doi.org/10.3349/ymj.2009.50.1.89
  21. Campos GM, Peters JH, DeMeester TR, et al. Multivariate analysis of factors predicting outcome after laparoscopic Nissen fundoplication. J Gastrointest Surg 1999;3:292-300. https://doi.org/10.1016/S1091-255X(99)80071-7
  22. Zhang Q, Lehmann A, Rigda R, Dent J, Holloway RH. Control of transient lower oesophageal sphincter relaxations and reflux by the GABA(B) agonist baclofen in patients with gastro-oesophageal reflux disease. Gut 2002;50:19-24. https://doi.org/10.1136/gut.50.1.19
  23. Boeckxstaens GE, Beaumont H, Hatlebakk JG, et al. A novel reflux inhibitor lesogaberan (AZD3355) as add-on treatment in patients with GORD with persistent reflux symptoms despite proton pump inhibitor therapy: a randomised placebocontrolled trial. Gut 2011;60:1182-1188. https://doi.org/10.1136/gut.2010.235630
  24. Kaltenbach T, Crockett S, Gerson LB. Are lifestyle measures effective in patients with gastroesophageal reflux disease? an evidence-based approach. Arch Intern Med 2006;166: 965-971. https://doi.org/10.1001/archinte.166.9.965
  25. Jacobson BC, Somers SC, Fuchs CS, Kelly CP, Camargo CA Jr. Body-mass index and symptoms of gastroesophageal reflux in women. N Engl J Med 2006;354:2340-2348. https://doi.org/10.1056/NEJMoa054391
  26. Comay D, Adam V, da Silveira EB, Kennedy W, Mayrand S, Barkun AN. The Stretta procedure versus proton pump inhibitors and laparoscopic Nissen fundoplication in the management of gastroesophageal reflux disease: a cost-effectiveness analysis. Can J Gastroenterol 2008;22:552-558. https://doi.org/10.1155/2008/765458
  27. Testoni PA, Vailati C, Testoni S, Corsetti M. Transoral incisionless fundoplication (TIF 2.0) with EsophyX for gastroesophageal reflux disease: long-term results and findings affecting outcome. Surg Endosc 2012;26:1425-1435. https://doi.org/10.1007/s00464-011-2050-1
  28. Hershcovici T, Fass R. Management of gastroesophageal reflux disease that does not respond well to proton pump inhibitors. Curr Opin Gastroenterol 2010;26:367-378. https://doi.org/10.1097/MOG.0b013e32833ae2be
  29. Fass R, Sontag SJ, Traxler B, Sostek M. Treatment of patients with persistent heartburn symptoms: a double-blind, randomized trial. Clin Gastroenterol Hepatol 2006;4:50-56. https://doi.org/10.1016/S1542-3565(05)00860-8
  30. Sgouros SN, Mantides A. Refractory heartburn to proton pump inhibitors: epidemiology, etiology and management. Digestion 2006;73:218-227. https://doi.org/10.1159/000094789
  31. Hungin AP, Rubin G, O'Flanagan H. Factors influencing compliance in long-term proton pump inhibitor therapy in general practice. Br J Gen Pract 1999;49:463-464.
  32. Gunaratnam NT, Jessup TP, Inadomi J, Lascewski DP. Sub-optimal proton pump inhibitor dosing is prevalent in patients with poorly controlled gastro-oesophageal reflux disease. Aliment Pharmacol Ther 2006;23:1473-1477. https://doi.org/10.1111/j.1365-2036.2006.02911.x
  33. Diener U, Patti MG, Molena D, Fisichella PM, Way LW. Esophageal dysmotility and gastroesophageal reflux disease. J Gastrointest Surg 2001;5:260-265. https://doi.org/10.1016/S1091-255X(01)80046-9
  34. Shay S, Sifrim D, Tutuian R, Zhang X, Vela M, Castello DO. Multichannel intraluminal impedance (MII) in the evaluation of patients with persistent GERD symptoms despite proton pump inhibitors (PPI): a multicenter study. Gastroenterology 2003;124(Suppl 1):A537.
  35. Zerbib F, Duriez A, Roman S, Capdepont M, Mion F. Determinants of gastro-oesophageal reflux perception in patients with persistent symptoms despite proton pump inhibitors. Gut 2008;57:156-160. https://doi.org/10.1136/gut.2007.133470
  36. Fass R, Murthy U, Hayden CW, et al. Omeprazole 40 mg once a day is equally effective as lansoprazole 30 mg twice a day in symptom control of patients with gastro-oesophageal reflux disease (GERD) who are resistant to conventional-dose lansoprazole therapy-a prospective, randomized, multi-centre study. Aliment Pharmacol Ther 2000;14:1595-1603. https://doi.org/10.1046/j.1365-2036.2000.00882.x
  37. Fass R, Murthy U, Hayden CW, et al. Omeprazole 40 mg once a day is equally effective as lansoprazole 30 mg twice a day in symptom control of patients with gastro-oesophageal reflux disease (GERD) who are resistant to conventional-dose lansoprazole therapy-a prospective, randomized, multi-centre study. Aliment Pharmacol Ther 2000;14:1595-1603. https://doi.org/10.1046/j.1365-2036.2000.00882.x
  38. Fass R, Sontag SJ, Traxler B, Sostek M. Treatment of patients with persistent heartburn symptoms: a double-blind, randomized trial. Clin Gastroenterol Hepatol 2006;4:50-56. https://doi.org/10.1016/S1542-3565(05)00860-8
  39. Furuta T, Shirai N, Watanabe F, et al. Effect of cytochrome P4502C19 genotypic differences on cure rates for gastroesophageal reflux disease by lansoprazole. Clin Pharmacol Ther 2002;72:453-460. https://doi.org/10.1067/mcp.2002.127637
  40. Sugimoto M, Shirai N, Nishino M, et al. Rabeprazole 10 mg q.d.s. decreases 24-h intragastric acidity significantly more than rabeprazole 20 mg b.d. or 40 mg o.m., overcoming CYP2C19 genotype. Aliment Pharmacol Ther 2012;36: 627-634. https://doi.org/10.1111/apt.12014
  41. Sharma P, Shaheen NJ, Perez MC, et al. Clinical trials: healing of erosive oesophagitis with dexlansoprazole MR, a proton pump inhibitor with a novel dual delayed-release formulation: results from two randomized controlled studies. Aliment Pharmacol Ther 2009;29:731-741. https://doi.org/10.1111/j.1365-2036.2009.03933.x
  42. Yang YX, Lewis JD, Epstein S, Metz DC. Long-term proton pump inhibitor therapy and risk of hip fracture. JAMA 2006;296:2947-2953. https://doi.org/10.1001/jama.296.24.2947
  43. Targownik LE, Lix LM, Metge CJ, Prior HJ, Leung S, Leslie WD. Use of proton pump inhibitors and risk of osteoporosisrelated fractures. CMAJ 2008;179:319-326. https://doi.org/10.1503/cmaj.071330
  44. Corley DA, Kubo A, Zhao W, Quesenberry C. Proton pump inhibitors and histamine-2 receptor antagonists are associated with hip fractures among at-risk patients. Gastroenterology 2010;139:93-101. https://doi.org/10.1053/j.gastro.2010.03.055
  45. Hansen KE, Jones AN, Lindstrom MJ, et al. Do proton pump inhibitors decrease calcium absorption? J Bone Miner Res 2010;25:2786-2795. https://doi.org/10.1002/jbmr.166
  46. Wright MJ, Sullivan RR, Gaffney-Stomberg E, et al. Inhibiting gastric acid production does not affect intestinal calcium absorption in young, healthy individuals: a randomized, crossover, controlled clinical trial. J Bone Miner Res 2010;25:2205-2211. https://doi.org/10.1002/jbmr.108
  47. Jo Y, Cho YK, Ahn SB, et al. Effect of proton pump inhibitors on bone metabolism in old age. Gastroenterology (abstract) 2012;142: S328.
  48. Valuck RJ, Ruscin JM. A case-control study on adverse effects: H2 blocker or proton pump inhibitor use and risk of vitamin B12 deficiency in older adults. J Clin Epidemiol 2004;57:422-428. https://doi.org/10.1016/j.jclinepi.2003.08.015
  49. Den Elzen WP, Groeneveld Y, de Ruijter W, et al. Long-term use of proton pump inhibitors and vitamin B12 status in elderly individuals. Aliment Pharmacol Ther 2008;27: 491-497. https://doi.org/10.1111/j.1365-2036.2008.03601.x
  50. Hess MW, Hoenderop JG, Bindels RJ, Drenth JP. Systematic review: hypomagnesaemia induced by proton pump inhibition. Aliment Pharmacol Ther 2012;36:405-413. https://doi.org/10.1111/j.1365-2036.2012.05201.x
  51. Leonard J, Marshall JK, Moayyedi P. Systematic review of the risk of enteric infection in patients taking acid suppression. Am J Gastroenterol 2007;102:2047-2056. https://doi.org/10.1111/j.1572-0241.2007.01275.x
  52. Tleyjeh IM, Bin Abdulhak AA, Riaz M, et al. Association between proton pump inhibitor therapy and clostridium difficile infection: a contemporary systematic review and meta-analysis. PLoS One 2012;7:e50836. https://doi.org/10.1371/journal.pone.0050836

Cited by

  1. 한의 복합치료로 호전된 불응성 위식도역류질환 (PPI-refractory GERD) 환자 1례 - 복진소견 평가를 중심으로 - vol.38, pp.5, 2017, https://doi.org/10.22246/jikm.2017.38.5.727