Body mass index and the efficacy of acid-mediating agents for GERD.
In studies of the association between obesity and gastroesophageal reflux, one subject that has received very little attention is the effect excess body mass may have on the effectiveness of acid-mediating agents. The lack of systematic research may reflect the perceived high clinical efficacy of drugs like proton pump inhibitors. Both proton pump inhibitors and histamine type 2 receptor antagonists have low rates of significant adverse events; if there are differences in the side effect profiles based on BMI, it is unlikely such associations would be detected. Also, while the metabolism of many drugs can be affected by body mass, it is not clear that such a relationship exists with acid-mediating agents. Nevertheless, there is evidence that body mass index may indeed be associated with the efficacy of proton pump inhibitors and histamine type 2 receptor antagonists. This review will examine that evidence and consider some of the possible pharmacokinetic effects that might relate to body mass index.
Jacobson
Brian C
BC
Section of Gastroenterology, Department of Medicine, Boston University Medical Center, 85 East Concord Street, Boston, MA 02118, USA. brian.jacobson@bmc.org
D000863:Antacids / Q000493:pharmacokinetics / Q000627:therapeutic use*; D015992:Body Mass Index; D004305:Dose-Response Relationship, Drug; D005764:Gastroesophageal Reflux / Q000188:drug therapy*; D006635:Histamine H2 Antagonists / Q000493:pharmacokinetics / Q000627:therapeutic use; D006801:Humans; D054328:Proton Pump Inhibitors / Q000493:pharmacokinetics / Q000627:therapeutic use; D016896:Treatment Outcome
D000863:Antacids; D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors