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 19 April 2018

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News

Sub-optimal PPI dosing prevalent in poorly controlled GERD

Most patients dose PPIs sub-optimally, and only 12% dose to maximize acid suppression, indicating that patients should be asked about dose timing to avoid costly dose escalations, finds the latest Alimentary Pharmacology & Therapeutics.

News image

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Proton pump inhibitors (PPIs) are the most potent drug treatment for gastro-esophageal reflux disease (GERD).

However, premeal dosing maximizes efficacy while sub-optimal dose timing may limit efficacy.

Dr Gunaratnam and colleagues determined the prevalence of sub-optimal PPI dosing in a community-based GERD population of 100 patients.

The investigative team questioned the patients about their proton pump inhibitor dosing habits and classified them as optimal or sub-optimal dosers.

Optimal dosers took proton pump inhibitors with or up to 60 minutes before meals.

39% were dosing more than 60 minutes before meals
Alimentary Pharmacology & Therapeutics

The investigators noted that sub-optimal dosers took proton pump inhibitors more than 60 minutes before meals, after meals, as needed, or at bedtime.

The investigative team found that 46% dosed optimally.

The team observed that 54 % dosed sub-optimally with 39% dosing more than 60 minutes before meals, 30% after meals, 28% at bedtime, and 4% as needed.

Only 6% of the subjects on once-daily proton pump inhibitor regimens dosed 15 to 30 minutes before a meal.

The team found that 33% of subjects taking proton pump inhibitors 2- to 3 times daily dosed in a manner that maximized acid suppression.

Dr Gunaratnam's team concludes, “In this study, 54% of patients dosed proton pump inhibitors sub-optimally, and only 12% dosed in a manner that maximized acid suppression.”

“As sub-optimal proton pump inhibitor dose timing can limit efficacy, patients with refractory symptoms should be asked about dose timing to avoid inappropriate and costly dose escalations.”

Aliment Pharmacol Ther 2006: 23(10): 1473
08 May 2006

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