Terapevticheskii arkhivTerapevticheskii arkhivТерапевтический архив0040-36602309-5342LLC Obyedinennaya Redaktsiya31727Editorial articleПередовая статьяReview ArticleInadequate response to proton pump inhibitor therapy: Causes and patient management tacticsНедостаточный ответ на терапию ингибиторами протонного насоса: причины и тактика ведения пациентовEvsiutinaIu VЕвсютинаЮ ВTrukhmanovA SТрухмановА СГБОУ ВПО "Первый МГМУ им. И.М. Сеченова" Минздрава России15022015872VOL 87, NO2 ()ТОМ 87, №2 (2015)858910042020Copyright ©; 2015, Consilium MedicumCopyright ©; 2015, ООО "Консилиум Медикум"2015Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://ter-arkhiv.ru/0040-3660/article/view/31727

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.

Аннотация. За последнее десятилетие значительно увеличилось число пациентов с гастроэзофагеальной рефлюксной болезнью и язвенной болезнью желудка и двенадцатиперстной кишки, у которых наблюдается недостаточный ответ на терапию ингибиторами протонного насоса (ИПН). В настоящее время большинство причин, снижающих ответ на лечение, выяснены. К сожалению, их не всегда можно устранить при помощи лекарственной терапии, но тем не менее в некоторых случаях применение рабепразола имеет ряд преимуществ по сравнению с другими ИПН. Главными причинами недостаточного ответа на терапию ИПН являются низкая мотивация к лечению, наличие ночных кислотных прорывов, генетически детерминированный полиморфизм CYP450, преимущественно ночная симптоматика гастроэзофагеальной рефлюксной болезни, наличие некислых рефлюксов, гиперсенситивный пищевод, избыточная масса тела и ожирение.

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