Análisis crítico de un artículo: La suspensión de inhibidores de la bomba de protones induciría síntomas de reflujo

Análisis crítico de un artículo: La suspensión de inhibidores de la bomba de protones induciría síntomas de reflujo

Background & Aims: Rebound acid hypersecretion (RAHS) has been demonstrated after 8 weeks of treatment with a proton-pump inhibitor (PPI). IfRAHS induces acid-related symptoms, this might lead to PPI dependency and thus have important implications. Methods: A randomized, double-blind, placeb...

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Autor principal: Candia B,Roberto
Lenguaje:Spanish / Castilian
Publicado: Sociedad Médica de Santiago 2012
Acceso en línea:http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872012000800017
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spelling oai:scielo:S0034-988720120008000172012-12-18Análisis crítico de un artículo: La suspensión de inhibidores de la bomba de protones induciría síntomas de reflujoCandia B,RobertoBackground &amp; Aims: Rebound acid hypersecretion (RAHS) has been demonstrated after 8 weeks of treatment with a proton-pump inhibitor (PPI). IfRAHS induces acid-related symptoms, this might lead to PPI dependency and thus have important implications. Methods: A randomized, double-blind, placebo-controlled trial with 120 healthy volunteers was conducted. Participants were randomized to 12 weeks of placebo or 8 weeks of esomeprazole 40 mg/d followed by 4 weeks with placebo. The Gastrointestinal Symptom Rating Scale (GSRS) was filled out weekly. A score of &gt;2 on 1 of the questions regarding heartburn, acid regurgitation, or dyspepsia was defined as a clinically relevant acid-related symptom. Results: There were no significant differences between groups in GSRS scores at baseline. GSRS scores for acid-related symptoms were significantly higher in the PPIgroup at week 10 (1.4 ± 1.4 vs 1.2 ± 0.9; P = .023), week 11 (1.4 ± 1.4 vs 1.2 ± 0.9; P = .009), and week 12 (1.3 ± 1.2 vs 1.0 ± 0.3; P = .001). Forty-four percent (26/59) of those randomized to PPI reported &gt;1 relevant, acid-related symptom in weeks 9-12 compared with 15% (9/59; P < .001) in the placebo group. The proportion reporting dyspepsia, heartburn, or acid regurgitation in the PPIgroup was 13 of 59 (22%) at week 10,13 of59 (22%) at week 11, and 12 of 58 (21%) at week 12. Corresponding figures in the placebo group were 7% at week 10 (P = .034), 5% at week 11 (P = .013), and 2% at week 12 (P = .001). Conclusions: PPI therapy for 8 weeks induces acid-related symptoms in healthy volunteers after withdrawal. This study indicates unrecognized aspects of PPI withdrawal and supports the hypothesis that RAHS has clinical implications.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.140 n.8 20122012-08-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872012000800017es10.4067/S0034-98872012000800017
institution Scielo Chile
collection Scielo Chile
language Spanish / Castilian
description Background &amp; Aims: Rebound acid hypersecretion (RAHS) has been demonstrated after 8 weeks of treatment with a proton-pump inhibitor (PPI). IfRAHS induces acid-related symptoms, this might lead to PPI dependency and thus have important implications. Methods: A randomized, double-blind, placebo-controlled trial with 120 healthy volunteers was conducted. Participants were randomized to 12 weeks of placebo or 8 weeks of esomeprazole 40 mg/d followed by 4 weeks with placebo. The Gastrointestinal Symptom Rating Scale (GSRS) was filled out weekly. A score of &gt;2 on 1 of the questions regarding heartburn, acid regurgitation, or dyspepsia was defined as a clinically relevant acid-related symptom. Results: There were no significant differences between groups in GSRS scores at baseline. GSRS scores for acid-related symptoms were significantly higher in the PPIgroup at week 10 (1.4 ± 1.4 vs 1.2 ± 0.9; P = .023), week 11 (1.4 ± 1.4 vs 1.2 ± 0.9; P = .009), and week 12 (1.3 ± 1.2 vs 1.0 ± 0.3; P = .001). Forty-four percent (26/59) of those randomized to PPI reported &gt;1 relevant, acid-related symptom in weeks 9-12 compared with 15% (9/59; P < .001) in the placebo group. The proportion reporting dyspepsia, heartburn, or acid regurgitation in the PPIgroup was 13 of 59 (22%) at week 10,13 of59 (22%) at week 11, and 12 of 58 (21%) at week 12. Corresponding figures in the placebo group were 7% at week 10 (P = .034), 5% at week 11 (P = .013), and 2% at week 12 (P = .001). Conclusions: PPI therapy for 8 weeks induces acid-related symptoms in healthy volunteers after withdrawal. This study indicates unrecognized aspects of PPI withdrawal and supports the hypothesis that RAHS has clinical implications.
author Candia B,Roberto
spellingShingle Candia B,Roberto
Análisis crítico de un artículo: La suspensión de inhibidores de la bomba de protones induciría síntomas de reflujo
author_facet Candia B,Roberto
author_sort Candia B,Roberto
title Análisis crítico de un artículo: La suspensión de inhibidores de la bomba de protones induciría síntomas de reflujo
title_short Análisis crítico de un artículo: La suspensión de inhibidores de la bomba de protones induciría síntomas de reflujo
title_full Análisis crítico de un artículo: La suspensión de inhibidores de la bomba de protones induciría síntomas de reflujo
title_fullStr Análisis crítico de un artículo: La suspensión de inhibidores de la bomba de protones induciría síntomas de reflujo
title_full_unstemmed Análisis crítico de un artículo: La suspensión de inhibidores de la bomba de protones induciría síntomas de reflujo
title_sort análisis crítico de un artículo: la suspensión de inhibidores de la bomba de protones induciría síntomas de reflujo
publisher Sociedad Médica de Santiago
publishDate 2012
url http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872012000800017
work_keys_str_mv AT candiabroberto analisiscriticodeunarticulolasuspensiondeinhibidoresdelabombadeprotonesinduciriasintomasdereflujo
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