Improvement of Non-Steroidal Anti-Inflammatory Drug-Induced Gastrointestinal Symptoms during Proton Pump Inhibitor Treatment: Are G-Protein β3 Subunit Genotype, Helicobacter pylori Status, and Environmental Factors Response Modifiers?
| Autor: | Peter Sander, Winfried Siffert, C. J. Van Rensburg, Thomas Schwan, Gerald Holtmann |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Adult
Male Drug medicine.medical_specialty Alcohol Drinking Genotype Gastrointestinal Diseases medicine.drug_class G protein media_common.quotation_subject Medizin Proton-pump inhibitor Pharmacology digestive system Gastroenterology 2-Pyridinylmethylsulfinylbenzimidazoles Helicobacter Infections Sex Factors Double-Blind Method β3 subunit Internal medicine parasitic diseases medicine Humans Pantoprazole Aged media_common Helicobacter pylori biology business.industry Anti-Inflammatory Agents Non-Steroidal Smoking Age Factors Proton Pump Inhibitors Middle Aged biology.organism_classification Heterotrimeric GTP-Binding Proteins digestive system diseases Intention to Treat Analysis population characteristics Female business human activities medicine.drug GNB3 |
| Zdroj: | Digestion. 84:289-298 |
| ISSN: | 1421-9867 0012-2823 |
| DOI: | 10.1159/000331468 |
| Popis: | Background: Non-steroidal anti-inflammatory drugs (NSAIDs) are associated with significant upper and lower gastrointestinal (GI) morbidity. Aim: To determine the efficacy and safety of pantoprazole versus placebo in controlling GI symptoms during treatment with NSAIDs and to evaluate the influence of potential response modifiers. Methods: 800 patients with GI complaints during NSAID treatment were randomized to pantoprazole 20 mg once daily or placebo for 4 weeks in this double-blind, multicenter trial. Assessments included the difference in cumulated overall symptom load of any GI complaint during treatment (primary endpoint), proportion of days without GI symptoms, and influence of risk factors such as gender, age, alcohol consumption, smoking, Helicobacter pylori status, and GNB3 genotype SNP rs5443 (825C>T) on symptom load. Results: At 4 weeks, cumulated overall symptom load was significantly lower in pantoprazole than placebo recipients [p < 0.0001; intent-to-treat (ITT)]; the effect was statistically significant after 7 days’ treatment. Pantoprazole versus placebo recipients had 54 versus 29% of days without GI symptoms (p < 0.0001; ITT). Neither common risk factors nor GNB3 genotype were significantly associated with therapeutic response, while GNB3 825TT versus CT was associated with a significantly higher baseline symptom load (p < 0.05). Conclusion: In the population studied, treatment with the proton pump inhibitor pantoprazole significantly improves GI symptoms during NSAID therapy, irrespective of the risk factors investigated or GNB3 genotype. |
| Databáze: | OpenAIRE |
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