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Discontinuation of proton pump inhibitors in patients on long-term therapy: a double-blind, placebo-controlled trial.

Artikel i vetenskaplig tidskrift
Författare Einar Björnsson
Hasse Abrahamsson
Magnus Simrén
N Mattsson
C Jensen
Pia Agerforz
Anders Kilander
Publicerad i Alimentary pharmacology & therapeutics
Volym 24
Nummer/häfte 6
Sidor 945-54
ISSN 0269-2813
Publiceringsår 2006
Publicerad vid Institutionen för medicin, avdelningen för invärtesmedicin
Sidor 945-54
Språk en
Länkar dx.doi.org/10.1111/j.1365-2036.2006...
Ämnesord Aged, Double-Blind Method, Drug Administration Schedule, Dyspepsia, blood, drug therapy, Enzyme Inhibitors, administration & dosage, Female, Gastrins, blood, Gastroesophageal Reflux, blood, drug therapy, Humans, Long-Term Care, Male, Middle Aged, Omeprazole, administration & dosage, Proton Pumps, antagonists & inhibitors, Quality of Life, Treatment Outcome, Withholding Treatment
Ämneskategorier Gastroenterologi

Sammanfattning

BACKGROUND: The proportion of proton pump inhibitor users on long-term therapy who can discontinue proton pump inhibitor (PPI) medication without developing symptoms is unknown. AIM: To determine the proportion of patients on long-term PPI therapy who are able to discontinue PPIs without developing symptoms. METHODS: Patients on long-term PPIs, without a history of peptic ulcer or esophagitis underwent upper endoscopy. Patients were randomized double-blindly to taper down or continue a constant dosage of omeprazole for three weeks. Thereafter, all patients discontinued PPIs. RESULTS: Of the 97 patients enrolled, had used PPIs for 48 months, 78% had GERD. A total of 27% did not use PPIs during the year after discontinuation, 31% of the patients randomized to tapering discontinued PPIs and 22% of those who did not could discontinue therapy (NS). Gastro-oesophageal reflux disease (GERD) patients were more prone to continue PPIs than non-GERD patients. Only 16 (21%) of GERD patients were off PPIs vs. 48% of patients without GERD (p < 0.05). Serum gastrin was higher at baseline in GERD patients who resumed PPIs versus non-resumers (p < 0.05). GERD and serum gastrin were independent predictors of PPI requirement. CONCLUSIONS: Discontinuation of PPI was successful in 27% of long-term PPI users. GERD patients had more difficulty discontinuing PPIs than non-GERD patients.

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