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Response to PPI uncertain after first week of treatment.(Clinical Rounds)
COPENHAGEN -- Some patients with dyspepsia not caused by reflux or a peptic ulcer who don't respond to a proton pump inhibitor in the first week of treatment will respond after a few more weeks of ongoing treatment, based on results from two studies with more than 1,000 patients each.
The first week on a proton pump inhibitor (PPI) "is only moderately useful for predicting responses after 4 and 8 weeks of treatment," Sander Veldhuyzen van Zanten, M.D., said at the 13th United European Gastroenterology Week. "It therefore makes sense to treat for 4-8 weeks" to see if the patient will eventually respond, said Dr. van Zanten, professor of medicine at Dalhousie University in Halifax, N.S.
The results also showed that a double dose of a PPI was no more effective than the standard dose when starting treatment.
"The data clearly show that in a primary care setting, unless a patient has alarming symptoms, there's no reason to start with a double dose of a PPI," Dr. van Zanten said.
One of the studies enrolled 1,250 patients, aged 18-50, who had epigastric pain or burning for at least 3 months, were negative for Helicobacter pylori, and had not been investigated by endoscopy. The study excluded patients whose predominant symptom was heartburn or acid regurgitation and those with more than one episode of heartburn or ...
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Source: HighBeam Research, Response to PPI uncertain after first week of treatment.(Clinical...