Safety and Efficacy of PPIs in Severe Acid-peptic Disease
Safety and Efficacy of PPIs in Severe Acid-peptic Disease
Our study shows that daily pantoprazole maintenance therapy for up to 15 years for severe acid-peptic disease is effective and well-tolerated, with no identified safety concerns. The moderate pantoprazole-induced hypergastrinaemia and its exerted effects on epithelium homoeostasis were not associated with any clinically relevant transformations of gastric mucosa. Furthermore, patients with successful H. pylori eradication in the course of the study showed long-term regression of antral and corpus gastritis during continued treatment with pantoprazole. The results of this study further support a test-and-treat strategy with regard to H. pylori infection prior to initiating long-term PPI treatment. A major strength of this study lies in the continuous collection of safety data and, in particular, gastric histological data over the course of 15 years of daily treatment with pantoprazole, the longest time period for analysis of any PPI study. In light of the early safety concerns around the effects of hypergastrinaemia, these results provide reassuring evidence for the long-term safety of pantoprazole.
Conclusions
Our study shows that daily pantoprazole maintenance therapy for up to 15 years for severe acid-peptic disease is effective and well-tolerated, with no identified safety concerns. The moderate pantoprazole-induced hypergastrinaemia and its exerted effects on epithelium homoeostasis were not associated with any clinically relevant transformations of gastric mucosa. Furthermore, patients with successful H. pylori eradication in the course of the study showed long-term regression of antral and corpus gastritis during continued treatment with pantoprazole. The results of this study further support a test-and-treat strategy with regard to H. pylori infection prior to initiating long-term PPI treatment. A major strength of this study lies in the continuous collection of safety data and, in particular, gastric histological data over the course of 15 years of daily treatment with pantoprazole, the longest time period for analysis of any PPI study. In light of the early safety concerns around the effects of hypergastrinaemia, these results provide reassuring evidence for the long-term safety of pantoprazole.
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