On-demand proton pump inhibitor therapy in patients with gastro-oesophageal reflux disease.
On-demand therapy is an established modality in long-term therapy with histamine-2-receptor antagonists, in cases of mild non-erosive gastro-oesophageal reflux disease. In the literature, only a few studies have specifically addressed the problem of proton pump inhibitors on-demand treatment. The evidence, so far, available suggests that this might be an effective modality of long-term treatment in the majority of patients with non-erosive gastro-oesophageal reflux disease. This treatment modality appears to be the most cost-effective and the best tolerated medical regimen for gastro-oesophageal reflux disease. It also seems to be able to restore the impairment of health-related quality of life due to gastro-oesophageal reflux disease symptoms. Although the current standard of care for patients with non-erosive gastro-oesophageal reflux disease is maintenance therapy with daily administration of a proton pump inhibitor agent, on-demand therapy, with the same drug, may be a reasonable long-term choice. The ideal proton pump inhibitors for such treatment will be those with a more rapid onset of action, more profound acid inhibition, more predictable therapeutic effect and less drug-drug interactions. Newer proton pump inhibitors, like esomeprazole, the S-chiral isomer of omeprazole, are promising drugs for on-demand treatment of gastro-oesophageal reflux disease.
Pace
F
F
Gastrointestinal Unit, L. Sacco University Hospital, University of Milan, Italy.
Pallotta
S
S
Bianchi Porro
G
G
D064098:Esomeprazole; D005764:Gastroesophageal Reflux / Q000188:drug therapy*; D006801:Humans; D009853:Omeprazole / Q000008:administration & dosage; D054328:Proton Pump Inhibitors; D011899:Ranitidine / Q000008:administration & dosage
D054328:Proton Pump Inhibitors; D011899:Ranitidine; D009853:Omeprazole; D064098:Esomeprazole