title: Review article: acid-related disease--what are the unmet clinical needs?
abstract: Proton pump inhibitors have dramatically improved the management options available for patients with acid-related disorders. In patients with gastro-oesophageal reflux disease, currently available proton pump inhibitors provide an excellent outcome for the majority; however, they do not provide optimal pH control in many. Proton pump inhibitors co-therapy reduces, but does not eliminate, the risk of gastrointestinal ulcers and complications in patients taking non-steroidal anti-inflammatory drugs, while in patients with upper gastrointestinal bleeding, it may be difficult to reach and maintain the current therapeutic target of intragastric pH of 6-7. This article reviews the effectiveness of current antisecretory therapy in these three acid-related diseases and areas of unmet clinical need. The potential role of a proton pump inhibitor with an extended duration of action and enhanced acid control from a single daily dose, particularly improved control at night, is discussed. Finally, therapy that could be administered without regard to time of day and/or food intake would offer dosing flexibility and thus have a positive effect on patients' compliance.
authors.affiliation: Division of Gastroenterology, Albert Einstein Medical Center, Philadelphia, PA 19141, USA. katzp@einstein.edu
authors.forename: P O
authors.initials: PO
authors.lastname: Katz
authors.forename: J M
authors.initials: JM
authors.lastname: Scheiman
authors.forename: A N
authors.initials: AN
authors.lastname: Barkun
mesh_terms: D000863:Antacids / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D005764:Gastroesophageal Reflux / Q000188:drug therapy; D005767:Gastrointestinal Diseases / Q000139:chemically induced / Q000188:drug therapy*; D006471:Gastrointestinal Hemorrhage / Q000188:drug therapy; D006801:Humans; D006863:Hydrogen-Ion Concentration; D010437:Peptic Ulcer / Q000188:drug therapy; D054328:Proton Pump Inhibitors
chemical_list: D000863:Antacids; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors