| Abstract | BACKGROUND & AIMS: The efficacy and safety of long-term acid suppression remains a subject for debate. We report data from patients with refractory reflux esophagitis who were undergoing maintenance therapy with >/=20 mg omeprazole daily for a mean period of 6.5 years (range, 1.4-11.2 years). METHODS: Patients with severe reflux esophagitis resistant to long-term therapy with H(2)-receptor antagonists and who were not eligible for surgery were evaluated at least annually for endoscopic relapse and histological changes in the gastric corpus. RESULTS: In 230 patients (mean age, 63 years at entry; 36% were >/=70 years), there were 158 relapses of esophagitis during 1490 treatment years (1 per 9.4 years), with no significant difference in relapse rates between Helicobacter pylori-positive and -negative patients. All patients rehealed during continued therapy with omeprazole at the same or higher dose. The annual incidence of gastric corpus mucosal atrophy was 4.7% and 0.7% in H. pylori-positive and -negative patients, respectively, which was mainly observed in elderly patients who had moderate/severe gastritis at entry. In patients with baseline moderate/severe gastritis, the incidences were similar: 7.9% and 8.4%, respectively. Corpus intestinal metaplasia was rare, and no dysplasia or neoplasms were observed. The adverse event profile was as might be expected from this elderly group of patients. CONCLUSIONS: Long-term omeprazole therapy (up to 11 years) is highly effective and safe for control of reflux esophagitis. |
| Authors | E C Klinkenberg-Knol, F Nelis, J Dent, P Snel, B Mitchell, P Prichard, D Lloyd, N Havu, M H Frame, J Romàn, A Walan, Long-Term Study Group
(Affiliation: Department of Gastroenterology, Free University Hospital, Amsterdam, The Netherlands. EC.Klinkenberg at azvu.nl)
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| Journal | Gastroenterology
(Gastroenterology)
Vol. 118
Issue 4
Pg. 661-9
(Apr 2000)
ISSN: 0016-5085 UNITED STATES |
| PMID | 10734017
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
|
| Chemical References |
- Anti-Ulcer Agents
- Gastrins
- Omeprazole
|
| Topics |
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Anti-Ulcer Agents
(adverse effects, therapeutic use)
- Barrett Esophagus
(etiology)
- Child
- Drug Resistance
- Esophagitis
(drug therapy, etiology)
- Female
- Gastric Mucosa
(drug effects)
- Gastrins
(blood)
- Gastritis
(etiology, microbiology, pathology)
- Gastroesophageal Reflux
(complications, drug therapy)
- Helicobacter Infections
- Humans
- Hyperplasia
- Male
- Middle Aged
- Omeprazole
(adverse effects, therapeutic use)
- Time Factors
- Treatment Outcome
|
