On-demand PPI Requirements in Patients With Endoscopy-Negative GERD

Juul-Hansen, Paul; Rydning, Andreas

doi:10.1097/01.mcg.0000139033.30945.7f

Cited by 10 publications

(13 citation statements)

References 17 publications

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“…The Medline and Cochrane search (final date December 24, 2006) resulted in 33 citations, of which 17 8–24 met inclusion criteria. Out of the 17 included studies: 13 8–12, 15–22 were conducted in GI clinics, three 16, 17, 23 in primary care, two were not RCTs but observational studies, 13, 14 two were primarily pharmacoeconomics studies, 17, 23 and the last, a study assessing the effect of an on‐demand strategy vs. a continuous maintenance on the health‐related quality of life 24…”

Section: Resultsmentioning

confidence: 99%

Systematic review: maintenance treatment of gastro‐oesophageal reflux disease with proton pump inhibitors taken ‘on‐demand’

Pace

Tonini

Pallotta

et al. 2007

Aliment Pharmacol Ther

101

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Section: Resultsmentioning

confidence: 99%

Systematic review: maintenance treatment of gastro‐oesophageal reflux disease with proton pump inhibitors taken ‘on‐demand’

Pace

Tonini

Pallotta

et al. 2007

Aliment Pharmacol Ther

101

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“…Monotherapy results in mean daily consumptions of 0.3–1 tablet a day [11,12,21,22], whereas in combination with antacids, needs of <0.5 PPI tablet a day were reported [23,24,25,26,27]. In all these studies, first-time consulting patients were included and on-demand treatment was initiated after a short period of standard treatment, which is the most ideal situation for titrating PPI needs.…”

Section: Discussionmentioning

confidence: 99%

Pharmacological Dependency in Chronic Treatment of Gastroesophageal Reflux Disease: A Randomized Controlled Clinical Trial

Velden

Wit²,

Quartero³

et al. 2009

Digestion

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Background: Despite evidence of the overuse of acid suppressive medication for gastroesophageal reflux disease (GERD), a transfer to noncontinuous therapy after long-term treatment proves difficult. Aim: To quantify the effect of blinded dosage reduction after long-term therapy on symptom control and quality of life while assessing pharmacological and placebo needs. Methods: Primary care patients with a history of GERD and long-term treatment were randomized to daily placebo with pantoprazole rescue (n = 141) or daily pantoprazole with placebo rescue (n = 62) upon relief after 4 weeks pantoprazole 20 mg. The number of rescue tablets, symptom control and generic quality of life were analyzed. Results: Measured from the daily placebo arm, 19% of the patients terminated treatment, 33% managed with 2–6 tablets/week, 38% needed a daily dosage and 10% needed more than a daily dosage in the long run. At these final dosages, symptom control and quality of life were dosage-independent and, furthermore, equal to values of patients on fixed daily pantoprazole. A temporal decrease in well-being was seen in 24% of the patients. Conclusion: A significant placebo response is apparent in long-term users of acid suppressive medication and pharmacological dependency is overestimated. Despite their history of long-term treatment, the majority of GERD patients can be switched from daily to on-demand treatment without impairing symptom control and quality of life.

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“…Thus, on-demand or intermittent therapy with a PPI is an attractive therapeutic strategy for NERD patients in clinical practice 104,105. These therapeutic approaches are convenient, allow patients to remain in control, cost effective, and decrease the likelihood of rebound of acid secretion.…”

Section: Treatmentmentioning

confidence: 99%

Nonerosive Reflux Disease (NERD) - An Update

Hershcovici¹,

Fass²

2010

J Neurogastroenterol Motil

120

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Recognizing nonerosive reflux disease (NERD) as a distinct presentation of gastroesophageal reflux disease (GERD) was one of the most important developments in the field of GERD in the last decade. Whilst the definition of NERD has not changed significantly over the years, the disorder accounts for the majority of the GERD patients and those who failed proton pump inhibitor (PPI) treatment. Recent developments in NERD focused primarily on understanding the pathophysiology and natural history. The introduction of esophageal impedance + pH has led to the assessment of other forms of gastroesophageal reflux in causing NERD. Therapeutic modalities still focus on acid suppression, but there is growing recognition that other therapeutic strategies should be considered in NERD.

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On-demand PPI Requirements in Patients With Endoscopy-Negative GERD

Abstract: 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.

Cited by 10 publications

References 17 publications

Systematic review: maintenance treatment of gastro‐oesophageal reflux disease with proton pump inhibitors taken ‘on‐demand’

Systematic review: maintenance treatment of gastro‐oesophageal reflux disease with proton pump inhibitors taken ‘on‐demand’

Pharmacological Dependency in Chronic Treatment of Gastroesophageal Reflux Disease: A Randomized Controlled Clinical Trial

Nonerosive Reflux Disease (NERD) - An Update

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