Effects of pumaprazole (BY841), a novel reversible proton pump antagonist, and of omeprazole, on intragastric acidity before and after cure of Helicobacter pylori infection

Abstract

INTRODUCTIONOmeprazole, an irreversible proton pump inhibitor, produces higher intragastric pH values in the presence of Helicobacter pylori infection than after cure of the infection, both in healthy subjects 1, 2 and in patients with duodenal ulcer disease. 3 The mechanism underlying this effect is still unclear. Two possible explanations have been put forward: (1) decreased production of ammonia or other neutralizing substances after cure of the infection, 4, 5 or (2) development of body gastritis during omeprazole therapy in H. pylori-positive subjects leading to decreased acid secretion. 6,7 Other hypotheses include H. pylori-related changes in acid output, 8±10 SUMMARYBackground: Omeprazole produces a higher intragastric pH in the presence of Helicobacter pylori infection than after cure. Aim: To investigate whether this effect also occurs with pumaprazole (BY841), a reversible proton pump antagonist which, in contrast to omeprazole, does not require activation in the acid compartment of the parietal cell. Methods: In a randomized, crossover, double-blind study, 24-h intragastric pH was measured in 13 H. pylori-positive subjects before and after a 1-week course of omeprazole (20 mg o.d.) or of pumaprazole (100 mg b.d.). The studies were repeated after the infection was cured. Results: In the absence of drug administration, the median 24-h pH values before cure (median 2.0, 90% CI: 1.2±3.2) did not differ from those after cure (median 1.5, 90% CI: 1.3±2.2; P 0.115). The 24-h pH values

Effective administration method of intravenous proton pump inhibitor: A novel testing using a BRAVO catheterless pH monitoring system

“…For factors influencing pH, only H. pylori was significant, which confirms previous reports that H. pylori-positive patients have higher suppression effects against gastric secretion (18,19). This study found that there were no differences in baseline pH between H. pylori-positive and -negative patients, but the % time of pH >4 and >6 for 48 h showed significant differences after the use of PPI.…”

Early effects of Lansoprazole orally disintegrating tablets on intragastric pH in CYP2C19 extensive metabolizers

“…As the present study is on the effect on the first day after a single dose of PPIs, both RPZ and LPZ are considered to be influenced by CYP2C19 genotype status. Previous reports have indicated that H pylori infection of the gastric mucosa potentiates the effects of proton pump inhibitors [40,41] . Therefore, in the present study, the study subjects were all H pylori-negative CYP2C19 EMs.…”

A Comprehensive Review of the Pharmacodynamics, Pharmacokinetics, and Clinical Effects of the Neutral Endopeptidase Inhibitor Racecadotril

“…A sixth randomized study directly comparing racecadotril and loperamide in the treatment of acute diarrhea was performed in a pediatric population with a mean age of 4.7 years (range 2–10 years) in a double-blind, double-placebo design (Turck et al, 1999). Fifty-two children received 1.5 mg/kg racecadotril thrice daily and 50 received 0.03 mg/kg loperamide thrice daily.…”