Novel methods of using proton-pump inhibitors.
On-demand therapy with PPIs is a new strategy that has been shown to be effective in patients with nonerosive reflux disease or mild erosive reflux disease. This strategy can reduce the cost of maintenance therapy substantially and is particularly appealing in patients with no evidence of mucosal disease. The long-term efficacy and safety of this form of therapy have not been established. Nocturnal reflux may be important in patients with complicated reflux disease or Barrett's esophagus. Data on combining PPIs with H2RAs suggest that nocturnal gastric pH can be controlled by the administration of H2RAs at bedtime. There are few data on nocturnal symptoms, and some studies suggest that tachyphylaxis may develop with H2RA therapy. More data are required on the clinical effectiveness of combination therapy administered long-term.
Vakil
Nimish
N
University of Wisconsin Medical School, Aurora Sinai Medical Center, 945 North 12th Street, Room 4040, Milwaukee, WI 53233, USA. nvakil@facstaff.wisc.edu
D003362:Cost-Benefit Analysis; D004359:Drug Therapy, Combination; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D005764:Gastroesophageal Reflux / Q000188:drug therapy* / Q000191:economics; D006635:Histamine H2 Antagonists / Q000627:therapeutic use*; D006801:Humans; D054328:Proton Pump Inhibitors; D016896:Treatment Outcome
D004791:Enzyme Inhibitors; D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors