Dr. Ronnie Fass discusses his manuscript “Maintenance of Heartburn Relief After Step-Down From Twice-Daily Proton Pump Inhibitor to Once-Daily Dexlansoprazole Modified Release.” To view the print version of this abstract go to www.cghjournal.org.
Hi my name is ronny fuss i’m a professor of medicine at university of arizona i’m also the chief of gastroenterology at southern arizona va healthcare system in tucson arizona today i will discuss an article that is published in the journal clinical gastroenterology and hepatology the article entitled maintenance of heartburn relief following step down from
Twice-daily prong pump inhibitor to once daily excellence of resolve amaura the background for this study is the fact that the most common patients with gastric sofitel reflux disease that we see in our practice today are those that fail ppi treatment as a result many of these patients are on more than once daily ppi unfortunately research that attempted to develop
New products for patients who fail ppi treatment did not meet great success consequently we attempted in this study to evaluate the value of excellence offers of 30 milligram once daily given to patients who required at least twice daily ppi in a split dose to control their symptoms in this study we recruited 178 patients all of them had to demonstrate that they
Require at least twice daily ppi to control their symptoms the ppi was given half an hour before breakfast and heaven armed before dinner and there was no specific brand of ppi that was required for enrollment into the current study at the end only 142 patients were available for efficacy analysis all these patients went through a baseline period where they had
To demonstrate the twice daily ppi fully controlled their symptoms subsequently patients received excellence offers of 30 milligram in the morning and placebo in the evening this drug were concealed so patients could not know which one was the medication and which one was the perceiver patient patients received the medications for a period of six weeks during that
Period of time patients filled an electronic diary twice a day once in the morning and once in the evening assessment of symptom severity in the study was done using puppies same questionnaire an assessment of quality of life at the end of the study was done with the public wall questionnaire the results of the study demonstrated that we were able to step down 88 of
88 percent of the patients that required twice daily ppi to once daily text on servers of 30 milligram we were also able to show that all these patients were able to maintain the same symptom control as they did on twice daily ppi and they were also able to maintain the same quality of life there were no specific complications reported during this study now what
Are the clinical implication of such a study well first of all we were able to show that we can maintain patients are required twice daily ppi on once their lead excellence offers of 30 milligram there are many studies demonstrating that compliance is an important factor in patients who fail bpi more than once a day there is sufficient evidence to demonstrate the
Patients are required more than once a day ppi have 30% decrease in their compliance by being able to maintain these patients symptom control on once daily ppi we can clearly improve their compliance furthermore patients that require long-term treatment with more than once a day ppi are increased risk of developing a variety of long-term complications of chronic
Ppi treatment they include osteoporosis wrist spine fractures nosocomial pneumonia and tarik non enteric infections mineral vitamin deficiencies as well as others by reducing the number of pps that patients have to take on a regular basis in order to control their symptoms one may reduce the risk of these patients in developing these chronic complications so in
Summary in this study then he then enrolled patients who required twice daily ppi to control their gerd related symptoms we were able to demonstrate that we can step down 88% of these patients to once daily dextran suffers of 30 milligram by doing that we are able to improve patients compliance with their anti reflux treatment and potentially we may reduce the risk
Of chronic ppi treatment in this patient population thank you
Transcribed from video
Maintenance of Heartburn Relief After Step-Down From Twice-Daily Proton Pump… By AmerGastroAssn