RISK-BENEFIT ASSESSMENT OF OMEPRAZOLE IN THE TREATMENT OF GASTROINTESTINAL DISORDERS

被引：24

作者：

CREUTZFELDT, W

机构：

[1] Department of Medicine, Georg-August-University, Göttingen

[2] Department of Medicine, University of Göttingen, Göttingen, D-37075

来源：

DRUG SAFETY | 1994年 / 10卷 / 01期

关键词：

D O I：

10.2165/00002018-199410010-00005

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

For the treatment of duodenal and gastric ulcer and reflux oesophagitis, especially erosive oesophagitis, omeprazole has an advantage over histamine H-2-receptor antagonists because it heals significantly more patients significantly faster. Adverse effects have been observed during short term treatment with the same frequency as during treatment with H-2-antagonists. Also, maintenance treatment with omeprazole of reflux oesophagitis is significantly superior to H-2-antagonist therapy. During long term treatment for up to 8 years no further drug-related adverse effects have been observed. Moderate hypergastrinaemia occurs in some patients, especially if an omeprazole dosage of 40 mg/day is needed. A slight increase of the agyrophil (endocrine) cell volume density and an extension of micronodular hyperplasia in the oxyntic mucosa after several years of omeprazole treatment seem to be related to the severity of the corpus gastritis and not to drug-induced hypergastrinaemia, because similar changes have been observed in equal frequency in patients not receiving antisecretory drugs. Theoretical arguments against long term treatment with potent acid-suppressing drugs, such as the possible consequences of gastric bacterial overgrowth or hypergastrinaemia, are not supported by clinical observations and epidemiological data and are, therefore, speculative.

引用

页码：66 / 82

页数：17

共 151 条

[21]

Brunner G.H.G., Thiesemann C., The potential clinical role of intravenous omeprazole, Digestion, 51, pp. 17-20, (1992)

[22]

Burget D.W., Chiverton S.G., Hunt R.H., Is there an optimal degree of acid suppression for healing of duodenal ulcers?, Gastroenterology, 99, pp. 345-351, (1990)

[23]

Burlinson B., Morriss S.H., Gatehouse D.G., Tweats D.J., Genotoxicity studies of gastric acid inhibiting drugs, Lancet, 335, pp. 419-420, (1990)

[24]

Carter D.C., Cancer after peptic ulcer surgery, Gut, 28, pp. 921-923, (1987)

[25]

Caygill C.P.J., Hill M.J., Malignancy following surgery for benign peptic disease: a review, Italian Journal of Gastroenterology, 24, pp. 218-224, (1992)

[26]

Cederberg C., Andersson T., Skanberg I., Omeprazole: pharmacokinetics and metabolism in man, Scandinavian Journal of Gastroenterology, 166, pp. 33-40, (1989)

[27]

Caygill C.P.J., Hill M.J., Hall C.N., Kirkham J.S., Northfield T.C., Increased risk of cancer at multiple site after gastric surgery for peptic ulcer, Gut, 28, pp. 924-928, (1987)

[28]

Caygill C.P.J., Hill M.J., Kirkham J.S., Northfield T.C., Mortality from gastric cancer following gastric surgery for peptic ulcer, Lancet, 1, pp. 929-931, (1986)

[29]

Cederberg C., Thoon A.B.R., Mahachai V., Westin J.A., Kirdeikis P., Et al., Effect of intravenous and oral omeprazole on 24-hour intragastric acidity in duodenal ulcer patients, Gastroenterology, 103, pp. 913-918, (1992)

[30]

Colin-Jones D.G., Langman M.J.S., Lawson D.H., Logan R.F.A., Patterson K.R., Et al., Post-marketing surveillance of the safety of Cimetidine for up to ten years

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