Inadequate response to proton pump inhibitor therapy: Causes and patient management tactics


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Abstract

The past decade has been marked by a considerable increase in the number of patients with gastroesophageal reflux disease and gastroduodenal ulcer who show an inadequate response to proton pump inhibitor (PPI) therapy. At the present time, most of the causes diminishing the response have been elucidated. Unfortunately, they cannot always be eliminated by drug therapy; nonetheless, rabeprazole has a number of advantages over other PPIs. The major causes of an inadequate response to PPI therapy are low treatment motivation; nocturnal gastric acid breakthroughs; genetically determined CYP polymorphism; chiefly nighttime symptoms of gastroesophageal reflux disease; non-acid refluxes; hypersensitive esophagus; overweight and obesity.

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Iu V Evsiutina

A S Trukhmanov

References

  1. Трухманов А.С. Гастроэзофагеальная рефлюксная болезнь: клинические варианты, прогноз, лечение: Автореф. дис. ... д-ра мед. наук. М 2008; 41.
  2. Маев И.В. Гастроэзофагеальная рефлюксная болезнь. Рос мед журн 2002; 3: 43-46.
  3. Kahrilas P.J., Boeckxstaens G., Smout A.J.P.M. Management of the Patient with Incomplete Response to PPI Therapy. Best Pract Res Clin Gastroenterol 2013; 27 (3): 401-414.
  4. Bell N.J.V., Burget D., Howden C.W. et al. Appropriate acid suppression for the management of gastro-esophageal reflux disease. Digestion 1992; 51 (suppl. 1): 59-67.
  5. Шептулин А.А. Современные возможности и перспективы лечения резистентных форм гастроэзофагеальной рефлюксной болезни. РЖГГК 2010; 6: 81-85.
  6. Cicala M., Emerenziani S., Guarino M.P., Ribolsi M. Proton pump inhibitor resistance, the real challenge in gastro-esophageal reflux disease. World J Gastroenterol 2013; 19 (39): 6529-6535.
  7. Hershcovici T., Fass R. An algorithm for diagnosis and treatment of refractory GERD. Best Pract Res Clin Gastroenterol 2010; 24: 923-936.
  8. Ивашкин В.Т., Шептулин А.А., Трухманов А.С. и др. Диагностика и лечение гастроэзофагеальной рефлюксной болезни. Пособие для врачей. М 2010.
  9. Ивашкин В.Т., Шептулин А.А., Трухманов А.С. и др. Рекомендации по обследованию и лечению больных гастроэзофагеальной рефлюксной болезнью. Пособие для врачей М 2005.
  10. Katz P.O., Gerson L.B., Vela M.F. Guidelines for the Diagnosis and Management of Gastroesophageal Refl ux Disease. Am J Gastroenterol 2013; 108: 308-328.
  11. Gunaratnam N.T., Jessup T.P., Inadomi J., Lascewski D.P. Sub-optimal proton pump inhibitor dosing is prevalent in patients with poorly controlled gastro-oesophageal reflux disease. Aliment Pharmacol Ther 2006; 23: 1473-1477.
  12. Cicala M., Emerenziani S., Guarino M.P., Ribolsi M. Proton pump inhibitor resistance, the real challenge in gastro-esophageal reflux disease. World J Gastroenterol 2013; 19 (39): 6529-6535.
  13. Chey W.D., Inadomi J.M., Booher A.M. et al. Primary-care physicians' perceptions and practices on the management of GERD: results of a national survey. Am J Gastroenterol 2005; 100: 1237-1242.
  14. Barnett J.L., Robinson M. Optimizing acid-suppression therapy. Manag Care 2001; 10 (1 Suppl): 17-21.
  15. Mcquab K.R., Laine L. Early heartburn relief with proton pump inhibitors: a systematic review and meta-analysis of clinical trials. Clin Gastroenterol Hepatol 2005; 3: 553-563.
  16. Tutuian R., Katz P.O., Castell D.O. Nocturnal acid breakthrough, drugs and bugs. Eur J Gastroenterol Hepatol 2004; 16: 441-463.
  17. Hunt R.H, Yuan Y., Yaghhoobi M. GERD: new strategies and new failures. J Clin Gastroenterol 2007; 41 (suppl. 2): 72-77.
  18. Aguilar D.B.B., Johnson D., McGuigan L.F. et al. Night-time and daytime atypical manifestations of gastro-oesophageal reflux disease: frequency, severity and impact on health-related quality of life. Aliment Pharmacol Ther 2008; 27: 327-337.
  19. Fornari F., Blondeau K., Mertens V. et al. Nocturnal gastroesophageal reflux revisited by impedance-pH monitoring, J Neurogastroenterol Motil 2011;17: 148-159.
  20. Сторонова О.А., Трухманов А.С., Джахая Н.Л. Нарушения пищеводного клиренса при гастроэзофагеальной рефлюксной болезни и возможности их коррекции. РЖГГК 2012; 2: 14-21.
  21. Lagergren J., Bergström R., Lindgren A. et al. Symptomatic gastroesophageal reflux as a risk factor for esophageal adenocarcinoma. N Engl J Med 1999; 340: 825-831.
  22. Miner P., Delemos B., Xiang J. et al. Effects of a single dose of rabeprazole 20 mg and pantoprazole 40 mg on 24-h intragastric acidity and oesophageal acid exposure: a randomized study in gastro-oesophageal reflux disease patients with a history of nocturnal heartburn. Aliment Pharmacol Ther 2010; 31 (9): 991-1000.
  23. Warrington S., Baisley K., Boyce M. et al. Effects of rabeprazole, 20 mg, or esomeprazole, 20 mg, on 24-h intragastric pH and serum gastrin in healthy subjects. Aliment Pharmacol Ther 2002; 16 (7): 1301-1307.
  24. Ariizumi K., Ohara S., Koike T. et al. Therapeutic effects of 10 mg/day rabeprazole administration on reflux esophagitis was not influenced by the CYP2C19 polymorphism. J Gastroenterol Hepatol 2006; 21: 1428-1434.
  25. Ishizaki T., Horai Y. Review article: cytochrome P450 and the metabolism of proton pump inhibitors - emphasis on rabeprazole. Aliment Pharmacol Ther 1999; 13 (Suppl 3): 27-36.
  26. Saitoh T., Otsuka H., Kawasaki T. et al. Influences of CYP2C19 Polymorphism on Recurrence of Reflux Esophagitis during Proton Pump Inhibitor Maintenance Therapy. Hepatogastroenterology 2009; 56: 703-706.
  27. Furuta Т., Shirai N., Watanabe F. et al. Effect of cytochrome P4502C19 genotypic differences on cure rates for gastroesophageal reflux disease by lansoprazole. Clin Pharmacol Ther 2002; 72 (4): 453-460.
  28. Ивашкин В.Т., Лапина Т.Л. Рациональная фармакотерапия заболеваний органов пищеварения. М: Литтерра 2006.
  29. Kuo C.H., Wang S.S., Hsu W.H. et al. Rabeprazole Can Overcome the Impact of CYP2C19 Polymorphism on Quadruple Therapy. Helicobacter 2010; 15 (4): 265-272.
  30. Zhao F., Wang J., Yang Y. et al. Effect of CYP2C19 Genetic Polymorphisms on the Efficacy of Proton Pump Inhibitor-Based Triple Therapy for Helicobacter pylori Eradication: A Meta-Analysis. Helicobacter 2008; 13: 532-541.
  31. Samer C.F., Ing L.K., Rollason V. Applications of CYP450 Testing in the Clinical Setting. Mol Diagn Ther 2013; 17: 165-184.
  32. Sim S.C., Risinger C., Dahl M.L. et al. A common novel CYP2C19 gene variant causes ultrarapid drug metabolism relevant for the response to proton pump inhibitors and antidepressants. Clin Pharmacol Ther 2006; 79: 103-113.
  33. Pharmacogenetics Working Group of the Royal Dutch Pharmacists Association, 2014.
  34. Kunsch S., Neesse A., Linhart T. et al. Prospective evaluation of duodenogastroesophageal reflux in gastroesophageal reflux disease patients refractory to proton pump inhibitor therapy. Digestion 2012; 86 (4): 315-322.
  35. Ribolsi М., Savarino E., De Bortoli N. et al. Reflux pattern and role of impedance-pH variables in predictihg IPP response in patients with suspected GERD-related chronic cough. Abstracts of the 20th National Congress of Digestive Diseases / Digestive and Liver Disease 46S (2014) S1-S144. OC.02.2.
  36. Sharma N., Agrawal A., Freeman J. et al. An analysis of persistent symptoms in acid-suppressed patients undergoing impedance-pH monitoring. Clin Gastroenterol Hepatol 2008; 6: 521-524.
  37. Karamanolis G., Vanuytsel T., Sifrim D. et al. Yield of 24-hour esophageal pH and Bilitec monitoring in patients with persistent symptoms on PPI therapy. Dig Dis Sci 2008; 53: 2387-2393.
  38. Charbel S., Khandwala F., Vaezi M.F. The role of esophageal pH monitoring in symptomatic patients on PPI therapy. Am J Gastroenterol 2005; 100: 283-289.
  39. Кайбышева В.О., Сторонова О.А., Трухманов А.С., Ивашкин В.Т. Возможности внутрипищеводной рН-импедансометрии в диагностике ГЭРБ. РЖГГК 2013; 2: 4-16.
  40. Mainie I., Tutuian R., Shay S. et al. Acid and non-acid reflux in patients with persistent symptoms despite acid suppressive therapy: a multicentre study using combined ambulatory impedance-pH monitoring. Gut 2006; 55 (10): 1398-1402.
  41. Karamanolis G.P., Sifrim D . Patients with refractory gastroesophageal reflux disease: diagnostic tools. Ann Gastroenterol 2013; 26 (1): 6-10.
  42. Viazis N., Keyoglou A., Kanellopoulos A.K. et al. Selective serotonin reuptake inhibitors for the treatment of hypersensitive esophagus: A placebo controlled study using esophageal pH-impedance monitoring. Am J Gastroenterol 2012; 107: 1662-1667.
  43. Paul С., Friedenberg F. Obesity and GERD. Gastroenterol Clin 2014; 43: 161-173.
  44. Kouklakis G., Moschos J., Kountouras J. Relationship between obesity and gastroesophageal reflux disease as recorded by 3-hour esophageal pH monitoring. Rom J Gastroenterol 2005; 14 (2): 117-121.
  45. El-Serag H.B., Ergun G.A., Pandolfino J. et al. Obesity increases oesophageal acid exposure. Gut 2007; 56: 749-755.
  46. Трухманов А.С., Джахая Н.Л., Кайбышева В.О., Сторонова О.А. Новые аспекты рекомендаций по лечению больных гастроэзофагеальной рефлюксной болезнью. Гастроэнтерол гепатол 2013; 1 1-9.
  47. Wu J.C., Mui L.M., Cheung C.M. et al. Obesity is associated with increased transient lower esophageal sphincter relaxation. Gastroenterology 2007; 132 (3): 883-889.
  48. Durk R. de Vries, Margot A. van Herwaarden, Andre J.P.M. Smout, Melvin Samsom. Gastroesophageal Pressure Gradients in Gastroesophageal Reflux Disease: Relations With Hiatal Hernia, Body Mass Index, and Esophageal Acid Exposure. Am J Gastroenterol 2008; 103: 1349-1354.
  49. Hampel H., Abracham N., El-Serag H.B. Meta-analysis: obesity and the risk of GERD and its complications. Ann Int Med 2005; 143 (3): 199-211
  50. Kromer W., Krüger U., Huber R. et al. Differences in pH-Dependent Activation Rates of Substituted Benzimidazoles and Biological in vitro Correlates. Pharmacology 1998; 56: 57-70.
  51. Jacobson B.C., DeLemos B., Sun Y. PPI Efficacy in overweight/obese patients with erosive GERD: rabeprazole (RAB) 20 mg vs. omeprazole (OME) 20 mg. Am J Gastroenterol 2007; 102 (Suppl 2): S150.
  52. Bor-Shyang Sheu, Wei-Lun Chang, Hsui-Chi Cheng et al. Body Mass Index Can Determine the Healing of Reflux Esophagitis With Los Angeles Grades C and D by Esomeprazole Am J Gastroenterol 2008; 103: 2209-2214.
  53. Hongo M., Miwa H., Kusano M.; J-FAST group. Effect of rabeprazole treatment on health-related quality of life and symptoms in patients with reflux esophagitis: a prospective multicenter observational study in Japan. J Gastroenterol 2011; 46: 297-304.
  54. Hongo M., Miwa H., Kusano M.; J-FAST group. Symptoms and quality of life in underweight gastroesophageal reflux disease patients and therapeutic responses to proton pump inhibitors. J Gastroenterol Hepatol 2012; 27 (5): 913-918.

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