Abstract | BACKGROUND: METHODS:
Lansoprazole was given for 3-48 months (median 28 months) to 26 Zollinger-Ellison syndrome patients with peptic ulcer manifestations in all and oesophagitis in 13. Starting with 60 mg/day. the dose was individualized to lower basal acid output to less than 5 mmol/h for those with intact stomachs and less than 1 mmol/h in those who had prior gastrectomy or with oesophagitis. The patients were studied every 3 months for 1 year and then every 6 months with gastric analysis (basal and maximal acid and pepsin output) and endoscopy with biopsy for enterochromaffin-like (ECL) cells. RESULTS:
Lansoprazole inhibited basal acid output by 95%, pepsin output by 65% and remained effective at the initial mean (66 +/- 4.3 mg/day) or smaller doses (56 +/- 12 mg/day) at 48 months. Mucosal lesions healed and symptoms ( ulcer-type pain, diarrhoea, heartburn, weight loss) resolved rapidly, usually within a few weeks. Serum gastrin and ECL cell populations, which were elevated before treatment, remained statistically unchanged but one of the three multiple endocrine neoplasia I (MEN-I) patients developed a small carcinoid. Of the three patients with metastatic gastrinoma at diagnosis one has died and one has progressed, while the third has had stable liver metastases for 26 years. Ulcer-type relapses occurred in three of the five post- gastrectomy patients, one with fatal jejunal ulcer perforation despite adequate acid suppression. No biochemical or clinical adverse events due to lansoprazole were encountered. CONCLUSION:
|
Authors | B I Hirschowitz, J Mohnen, S Shaw |
Journal | Alimentary pharmacology & therapeutics
(Aliment Pharmacol Ther)
Vol. 10
Issue 4
Pg. 507-22
(Aug 1996)
ISSN: 0269-2813 [Print] England |
PMID | 8853754
(Publication Type: Clinical Trial, Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
|
Chemical References |
- 2-Pyridinylmethylsulfinylbenzimidazoles
- Anti-Ulcer Agents
- Enzyme Inhibitors
- Gastrins
- Proton Pump Inhibitors
- Lansoprazole
- Pentagastrin
- Omeprazole
|
Topics |
- 2-Pyridinylmethylsulfinylbenzimidazoles
- Adult
- Aged
- Aged, 80 and over
- Anti-Ulcer Agents
(therapeutic use)
- Enzyme Inhibitors
(therapeutic use)
- Female
- Gastric Acid
(metabolism)
- Gastric Mucosa
(drug effects, metabolism, pathology)
- Gastrins
(metabolism)
- Humans
- Lansoprazole
- Male
- Middle Aged
- Omeprazole
(analogs & derivatives, therapeutic use)
- Patient Dropouts
- Pentagastrin
(pharmacology)
- Proton Pump Inhibitors
- Zollinger-Ellison Syndrome
(drug therapy)
|