Clinical significance of hypergastrinaemia: relevance to gastrin monitoring during omeprazole therapy.
During the early experience with omeprazole, it was recommended that plasma gastrin levels be monitored to identify patients with 4-5-fold increases above baseline. Such patients were thought to be at an increased risk of developing gastric carcinoid tumours. Studies have established that plasma gastrin levels usually rise 2-4-fold during omeprazole therapy, there being considerable inter- and intra-individual variation. Approximately 3.3% of patients have plasma gastrin levels above 400 pg/ml when treated continuously for 1 year. In clinical practice, it is not cost-effective to screen all patients to detect such a small percentage, particularly given the paucity of realistic treatment options in such patients, and the growing evidence that hypergastrinaemia during omeprazole treatment is of little, if any, clinical significance.
Freston
J W
JW
Department of Medicine, University of Connecticut, Farmington 06030.
D003110:Colonic Neoplasms / Q000453:epidemiology / Q000209:etiology; D016903:Drug Monitoring / Q000191:economics / Q000592:standards; D005215:Fasting; D005753:Gastric Mucosa / Q000187:drug effects / Q000473:pathology; D005755:Gastrins / Q000097:blood* / Q000187:drug effects; D006801:Humans; D009853:Omeprazole / Q000009:adverse effects*; D011899:Ranitidine / Q000009:adverse effects; D012008:Recurrence; D013274:Stomach Neoplasms / Q000453:epidemiology / Q000209:etiology; D014629:Vagotomy, Proximal Gastric / Q000592:standards
D005755:Gastrins; D011899:Ranitidine; D009853:Omeprazole