胃食管反流病(GERD)在印度的合并患病率为15.2%,在不同的患者亚组中表现不同。治疗GERD的方法包括使用单一疗法或OTC如抗酸剂和/或处方药如H2受体拮抗剂和质子泵抑制剂(PPI)的组合。与相同适应症的其他药物相比,PPI的更好疗效和安全性有助于其广泛使用。在PPI中,在印度,大多数医疗保健专业人员更喜欢开泮托拉唑。标准剂量的泮托拉唑(40毫克)无法满足食管外症状的需要,部分响应者,同时使用非甾体类抗炎药(NSAIDs)的患者,或超重/肥胖患者的严重表现。在这种情况下,多个指南建议将PPI的剂量加倍。每日两次给药PPI可能会降低依从性。因此,在这些病例中,需要每天1次给药更高剂量的泮托拉唑(80mg),以改善依从性,从而获得更好的结局.使用双释放泮托拉唑80毫克可能有助于改善依从性,并增加酸抑制发生的时间。在这次审查中,我们根据科学证据和临床医生的经验讨论了使用更高剂量的PPI.
■UpadhyayR,SoniNK,KotamkarAA,etal.高剂量泮托拉唑治疗胃食管反流病:需要,证据,指南和我们的经验。欧亚J肝胃肠病2024;14(1):86-91。
Gastroesophageal reflux disease (GERD) has a pooled prevalence of 15.2% in India with varying presentation in different subset of patients. The approach towards the management of GERD includes use of monotherapy or a combination of OTCs like antacids and/or prescription drugs like H2 receptor antagonists and proton pump inhibitors (PPI). Better efficacy and safety profile of PPIs have contributed to its wide spread use as compared with other drugs for the same indication. Among PPIs, most of the healthcare professionals prefer to prescribe
pantoprazole in India. Standard dose of
Pantoprazole (40 mg) is unable to meet the needs in case of extraesophageal symptoms, partial responders, patients with concomitant use of non-steroidal anti-inflammatory drugs (NSAIDs), or severe presentation in cases of overweight/obese patients. Multiple
guidelines recommend doubling the dose of PPI in such cases. Twice daily dosing of PPI may reduce compliance. Thus, there is a need for a higher dose of
Pantoprazole (80 mg) to be prescribed once daily in these cases so that improved compliance leads to better outcomes. The use of dual release Pantoprazole 80 mg may help to improve compliance and also enhance the time for which acid suppression takes place. In this review, we discuss the use of higher dose PPI based on scientific evidence and experience of clinicians for the same.
UNASSIGNED: Upadhyay R, Soni NK, Kotamkar AA, et al. High Dose
Pantoprazole for Gastroesophageal Reflux Disease: Need, Evidence,
Guidelines and Our Experience. Euroasian J Hepato-Gastroenterol 2024;14(1):86-91.