daw
11-05-2003, 03:42 PM
http://www.medicalpost.com/mpcontent/article.jsp;jsessionid=FCHHKCHAAPAI?content=200311 04_112839_3668
Use PPIs early to help avoid dysplasia
• Proton pump inhibitor (PPI) therapy can alter the progression of Barrett's esophagus to dysplasia, according to researchers at the Arizona Health Sciences Centre in Tucson.
The study, led by Dr. Thomas Aguirre, retrospectively compared the development of dysplasia in 56 Barrett's esophagus patients from a veterans' centre who had been treated with a PPI, an H2-receptor antagonist (H2RA) or no therapy.
The use of H2RA or PPI after Barrett's esophagus diagnosis was inversely associated with risk of dysplasia. However, the researchers found the cumulative incidence of dysplasia was significantly lower among patients who received PPI therapy after Barrett's esophagus diagnosis than in those who received no therapy or H2RA. The difference in cumulative incidence increased progressively with longer duration of followup.
The inverse relationship between PPI therapy and the development of dysplasia argues for the early and chronic use of PPIs, Dr. Aguirre and colleagues said.
Esomeprazole aids ulcers, GI symptoms
• Treatment with esomeprazole (40 mg and 20 mg) significantly reduces the development of gastroduodenal ulcers and associated upper gastrointestinal symptoms in high-risk patients using non-selective or COX-2 selective NSAIDs.
A research team, led by Dr. James Scheiman of the University of Michigan Medical Centre in Ann Arbor, randomized 585 H. pylori-negative patients who had taken non-selective or COX-2 selective NSAIDs for four weeks to receive esomeprazole 40 mg, esomeprazole 20 mg or placebo for six months. All patients underwent endoscopy and upper GI symptom evaluation at baseline, and after one, three and six months.
Overall, esomeprazole 40 mg and esomeprazole 20 mg treatment reduced the rate of ulcer recurrence by 64.2% and 57.7%, respectively, versus placebo at six months.
On esomeprazole, patients were also more likely to be without heartburn and acid regurgitation at six months.
Use PPIs early to help avoid dysplasia
• Proton pump inhibitor (PPI) therapy can alter the progression of Barrett's esophagus to dysplasia, according to researchers at the Arizona Health Sciences Centre in Tucson.
The study, led by Dr. Thomas Aguirre, retrospectively compared the development of dysplasia in 56 Barrett's esophagus patients from a veterans' centre who had been treated with a PPI, an H2-receptor antagonist (H2RA) or no therapy.
The use of H2RA or PPI after Barrett's esophagus diagnosis was inversely associated with risk of dysplasia. However, the researchers found the cumulative incidence of dysplasia was significantly lower among patients who received PPI therapy after Barrett's esophagus diagnosis than in those who received no therapy or H2RA. The difference in cumulative incidence increased progressively with longer duration of followup.
The inverse relationship between PPI therapy and the development of dysplasia argues for the early and chronic use of PPIs, Dr. Aguirre and colleagues said.
Esomeprazole aids ulcers, GI symptoms
• Treatment with esomeprazole (40 mg and 20 mg) significantly reduces the development of gastroduodenal ulcers and associated upper gastrointestinal symptoms in high-risk patients using non-selective or COX-2 selective NSAIDs.
A research team, led by Dr. James Scheiman of the University of Michigan Medical Centre in Ann Arbor, randomized 585 H. pylori-negative patients who had taken non-selective or COX-2 selective NSAIDs for four weeks to receive esomeprazole 40 mg, esomeprazole 20 mg or placebo for six months. All patients underwent endoscopy and upper GI symptom evaluation at baseline, and after one, three and six months.
Overall, esomeprazole 40 mg and esomeprazole 20 mg treatment reduced the rate of ulcer recurrence by 64.2% and 57.7%, respectively, versus placebo at six months.
On esomeprazole, patients were also more likely to be without heartburn and acid regurgitation at six months.