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Latest & greatest articles for proton pump inhibitors
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ProtonPumpInhibitors for Acute Upper GI Bleeding ProtonPumpInhibitors for Acute Upper GI Bleeding – TheNNTTheNNT ProtonPumpInhibitors (PPIs) Given for Acute Upper Gastrointestinal Bleeding Given Prior to Endoscopic Diagnosis No benefit found In Summary, for those who took the PPI: Benefits in NNT 100% saw no benefit 0% were helped by being saved from death, needing surgery, preventing repeat bleeding None were helped (life saved, preventing surgery, prevent repeat bleeding) Harms in NNT (...) gastrointestinal bleeding is a potentially life threatening condition that can demand aggressive intervention from the emergency physicians. Although bleeding can originate in any area above the ligament of Treitz, the majority of bleeding is from a peptic ulcer , . Protonpumpinhibitors (PPIs) work by reducing gastric acid secretion, neutralizing gastric pH, increasing clot formation and decreasing clot lysis . Intravenous protonpumpinhibitors have traditionally been used after endoscopic hemostasis
Effect of protonpumpinhibitors on clinical outcome in patients treated with clopidogrel: a systematic review and meta-analysis Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Meta-analysis: the effects of protonpumpinhibitors on cardiovascular events and mortality in patients receiving clopidogrel Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Meta-analysis: protonpumpinhibitor use and the risk of community-acquired pneumonia Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
ACCF/ACG/AHA 2010 Expert Consensus Document on the Concomitant Use of ProtonPumpInhibitors and Thienopyridines: A Focused Update of the ACCF/ACG/AHA 2008 Expert Consensus Document on Reducing the Gastrointestinal Risks of Antiplatelet Therapy and NSAID nature publishing group the red section 2533 Writing Committee Members Neena S. Abraham, MD, FACG, Chair*; Mark A. Hlatky, MD, FACC, FAHA, Vice Chair† Elliott M. Antman, MD, FACC, FAHA‡; Deepak L. Bhatt, MD, MPH, FACC, FAHA† David J. Bjorkman (...) KW , Quigley EM, Scheiman J, Sper - ling LS, Tomaselli GF (. ACCF/ACG/AHA 2010 expert consensus document on the concomitant use of protonpumpinhibitors and thienopyridines: a focused update of the ACCF/ACG/AHA 2008 expert consensus document on reducing the gastrointestinal risks of antiplatelet therapy and NSAID use. Am J Gastroenterol 2010;105:2533–2549; doi:10.1038/ajg.2010.445. This article has been copublished in the Journal of the American College of Cardiology and Circulation. Copies
Clinical trial: the effects of the protonpumpinhibitor dexlansoprazole MR on daytime and nighttime heartburn in patients with non-erosive reflux disease The proportion of patients who respond to protonpumpinhibitor (PPI) therapy is about 20% lower in those with non-erosive reflux disease (NERD) than in those with erosive oesophagitis.To assess efficacy and safety of dexlansoprazole MR, a PPI using Dual Delayed Release technology, in NERD patients.In this 4-week, double-blind, placebo
A population-based study of the drug interaction between protonpumpinhibitors and clopidogrel Most protonpumpinhibitorsinhibit the bioactivation of clopidogrel to its active metabolite. The clinical significance of this drug interaction is unknown.We conducted a population-based nested case-control study among patients aged 66 years or older who commenced clopidogrel between Apr. 1, 2002, and Dec. 31, 2007, following hospital discharge after treatment of acute myocardial infarction (...) following acute myocardial infarction, we identified 734 cases readmitted with myocardial infarction and 2057 controls. After extensive multivariable adjustment, current use of protonpumpinhibitors was associated with an increased risk of reinfarction (adjusted odds ratio [OR] 1.27, 95% confidence interval [CI] 1.03-1.57). We found no association with more distant exposure to protonpumpinhibitors or in multiple sensitivity analyses. In a stratified analysis, pantoprazole, which does not inhibit
Pharmacodynamic effect and clinical efficacy of clopidogrel and prasugrel with or without a proton-pumpinhibitor: an analysis of two randomised trials. Proton-pumpinhibitors (PPIs) are often prescribed in combination with thienopyridines. Conflicting data exist as to whether PPIs diminish the efficacy of clopidogrel. We assessed the association between PPI use, measures of platelet function, and clinical outcomes for patients treated with clopidogrel or prasugrel.In the PRINCIPLE-TIMI 44 (...) trial, the primary outcome was inhibition of platelet aggregation at 6 h assessed by light-transmission aggregometry. In the TRITON-TIMI 38 trial, the primary endpoint was the composite of cardiovascular death, myocardial infarction, or stroke. In both studies, PPI use was at physician's discretion. We used a multivariable Cox model with propensity score to assess the association of PPI use with clinical outcomes.In the PRINCIPLE-TIMI 44 trial, 201 patients undergoing elective percutaneous coronary
Protonpumpinhibitors for the prevention of stress-related mucosal disease in critically-ill patients: a meta-analysis Protonpumpinhibitors for the prevention of stress-related mucosal disease in critically-ill patients: a meta-analysis Protonpumpinhibitors for the prevention of stress-related mucosal disease in critically-ill patients: a meta-analysis Pongprasobchai S, Kridkratoke S, Nopmaneejumruslers C CRD summary The review found a significantly lower rate of clinically important (...) bleeding when using protonpumpinhibitors rather than histamine-2 receptor antagonists in the prevention of stress-related mucosal disease in critically ill patients. Rates of nosocomial pneumonia were similar. The reliability of the authors’ conclusions is unclear due to some methodological weaknesses and differences between the small number of studies. Authors' objectives To evaluate the effectiveness of protonpumpinhibitors compared to histamine-2 receptor antagonists in the prevention of stress
The effect of ranitidine versus protonpumpinhibitors on gastric secretions: a meta-analysis of randomised control trials Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Systematic review: standard- and double-dose protonpumpinhibitors for the healing of severe erosive oesophagitis - a mixed treatment comparison of randomized controlled trials Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Effect and cost-effectiveness of step-up versus step-down treatment with antacids, H2-receptor antagonists, and protonpumpinhibitors in patients with new onset dyspepsia (DIAMOND study): a primary-care-based randomised controlled trial. Substantial physician workload and high costs are associated with the treatment of dyspepsia in primary health care. Despite the availability of consensus statements and guidelines, the most cost-effective empirical strategy for initial management (...) , and protonpumpinhibitor (step-up; n=341), or these drugs in the reverse order (step-down; n=323), by use of a computer-generated sequence with blocks of six. Each step lasted 4 weeks and treatment only continued with the next step if symptoms persisted or relapsed within 4 weeks. Primary outcomes were symptom relief and cost-effectiveness of initial management at 6 months. Analysis was by intention to treat (ITT); the ITT population consisted of all patients with data for the primary outcome at 6
2009LancetControlled trial quality: predicted high
Cost effectiveness of COX 2 selective inhibitors and traditional NSAIDs alone or in combination with a protonpumpinhibitor for people with osteoarthritis Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Clinical trial: Radiofrequency energy delivery in protonpumpinhibitor-dependent gastro-oesophageal reflux disease patients Radiofrequency (RF) energy delivery is an endoscopic procedure developed for the treatment of gastro-oesophageal reflux disease.To compare RF and a protonpumpinhibitor strategy (PPI) in PPI-dependent patients by carrying out a prospective, randomized trial.Patients with PPI-dependent typical reflux symptoms were randomly allocated to either RF or PPI regimen alone
Esophageal pH-impedance monitoring in patients with therapy-resistant reflux symptoms: `on` or `off` protonpumpinhibitor? In patients with protonpumpinhibitor (PPI)-resistant symptoms, ambulatory 24-h pH-impedance monitoring can be used to assess whether a relationship exists between symptoms and reflux episodes. Until now, it is unclear whether combined pH-impedance monitoring in these patients should be performed on or off PPI.Thirty patients with symptoms of heartburn, chest pain
Proton-pumpinhibitor use and the risk for community-acquired pneumonia. Recent studies suggest that proton-pumpinhibitors (PPIs) may increase the risk for community-acquired pneumonia (CAP).To examine the association between PPI use and CAP in adults followed in general practices in the United Kingdom.Nested case-control study.The General Practice Research Database (1987 to 2002) in the United Kingdom.Patients age 18 years or older with at least 6 months of initial pneumonia-free follow-up (...) matched case-control analysis, which included the 3 strongest confounders as additional matching factors, yielded similar results as the primary analysis (adjusted OR, 0.96 [CI, 0.91 to 1.02]).Adherence to PPI prescription was assumed to be 100%. No radiographic evidence was available to corroborate a diagnosis of CAP.Proton-pumpinhibitor therapy started within the past 30 days was associated with an increased risk for CAP, whereas longer-term current use was not.
GI, Howden CW, Moayyedi P, Forman D. Protonpumpinhibitor treatment initiated prior to endoscopic diagnosis in upper gastrointestinal bleeding. Cochrane Database of Systematic Reviews 2006, Issue 4. Art. No.: CD005415. DOI: 10.1002/14651858.CD005415.pub2. Lau JY, Leung WK, Wu JC, et al. Omeprazole before endoscopy in patients with gastrointestinal bleeding. N Engl J Med 2007;356:1631-40. Barkun AN, Herba K, Adam V, et al. The cost-effectiveness of high-dose protonpumpinhibition after endoscopy (...) Cost-effectiveness of proton-pumpinhibition before endoscopy in upper gastrointestinal bleeding Cost-effectiveness of proton-pumpinhibition before endoscopy in upper gastrointestinal bleeding Cost-effectiveness of proton-pumpinhibition before endoscopy in upper gastrointestinal bleeding Al-Sabah S, Barkun A N, Herba K, Adam V, Fallone C, Mayrand S, Pomier-Layrargues G, Kennedy W, Bardou M Record Status This is a critical abstract of an economic evaluation that meets the criteria