Discontinuation of proton pump inhibitors in patients on long-term therapy:: a double-blind, placebo-controlled trial
Discontinuation of proton pump inhibitors in patients on long-term therapy:: a double-blind, placebo-controlled trial
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DOI：
10.1111/j.1365-2036.2006.03084.x
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发表时间：
2006-09-15
影响因子：
7.6
通讯作者：
Kilander, A.
中科院分区：
文献类型：
--
作者：
Bjornsson, E.;Abrahamsson, H.;Kilander, A.
Background the proportion of proton pump inhibitor users on long-term therapy who can discontinue proton pump inhibitor（PPI）medication without developing symptoms is unknown.Aim To determine the proportion of patients on long-term PPI therapy who are able to discontinue PPIs without developing symptoms.Methods Patients on long-term PPIs，without a history of peptic ulcer or esophageal itis experienced upper endoscopy.患者被随机双盲逐渐减少或继续三周的奥美拉唑恒定剂量。结果在97例使用PPIs 48个月的患者中，78%发生GERD。在停药后的一年内，共有27%的患者未使用PPI，31%的随机分配至逐渐减量的患者停用PPI，22%的患者无法停止治疗（NS）。胃食管反流病（GERD）患者比非GERD患者更倾向于继续PPI。仅16例（21%）GERD患者停用PPI，而非GERD患者为48%（p < 0.05）。基线时，重新开始PPI治疗的GERD患者的血清胃泌素水平高于未恢复PPI治疗的患者（p < 0.05）。GERD和血清胃泌素是独立的预测PPI requirement.Conclusions PPI停药是成功的27%的长期PPI用户。GERD患者比非GERD患者更难停用PPI。
Background The proportion of proton pump inhibitor users on long-term therapy who can discontinue proton pump inhibitor (PPI) medication without developing symptoms is unknown.Aim To determine the proportion of patients on long-term PPI therapy who are able to discontinue PPIs without developing symptoms.Methods Patients on long-term PPIs, without a history of peptic ulcer or esophagitis underwent upper endoscopy. Patients were randomized double-blindly to taper down or continue a constant dosage of omeprazole for three weeks. Thereafter, all patients discontinued PPIs.Results Of the 97 patients enrolled, had used PPIs for 48 months, 78% had GERD. A total of 27% did not use PPIs during the year after discontinuation, 31% of the patients randomized to tapering discontinued PPIs and 22% of those who did not could discontinue therapy (NS). Gastro-oesophageal reflux disease (GERD) patients were more prone to continue PPIs than non-GERD patients. Only 16 (21%) of GERD patients were off PPIs vs. 48% of patients without GERD (p < 0.05). Serum gastrin was higher at baseline in GERD patients who resumed PPIs versus non-resumers (p < 0.05). GERD and serum gastrin were independent predictors of PPI requirement.Conclusions Discontinuation of PPI was successful in 27% of long-term PPI users. GERD patients had more difficulty discontinuing PPIs than non-GERD patients.