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Antisecretory effects of three omeprazole regimens for maintenance treatment in duodenal ulcer

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Abstract

This study was carried out to assess the antisecretory effects and their possible changes over time of three different dose regimens of omeprazole that could be proposed for maintenance treatment in duodenal ulcer. Forty-five patients with endoscopically proven duodenal ulcer were studied by means of 24-hr gastric pH-metry both in basal conditions and on the fifth day of acute treatment with omeprazole 20 mg in the morning. Ulcers healed after four weeks (in three cases after eight weeks) and afterwards, 15 patients were randomized to receive orally at 0800 hr in single-blind fashion omeprazole 10 mg daily (group A), 15 to receive omeprazole 40 mg on Saturday and Sunday followed by a five-day period without medication (group B), and 15 to receive omeprazole 20 mg every other day (group C) for up to three months. On the 20th and 80th days of these maintenance treatments 24-hr gastric pH-metry was repeated to assess the antisecretory effectiveness of each regimen over a two-month period. In patients of group B these tests began at 1700 hr on Friday, the last of five days off treatment, and in those of group C at 1700 hr of the day off medication. All three dose regimens of omeprazole were able to raise pH values significantly (P<0.01–0.001) compared to basal levels. Omeprazole 20 mg every other day was more effective (P<0.01) than omeprazole 40 mg weekend, but did not differ significantly from omeprazole 10 mg daily. The durations of acid inhibition (pH>3.0 units/24 hr) were 12.44, 10.00, and 17.38 hr with groups A, B, and C, respectively. There was no significant difference between the pH profiles of the 20th and 80th days with every dose regimen. It is concluded that all three dose regimens of omeprazole are effective in reducing gastric acidity and their pharmacodynamic action does not change with time. Therefore they are suitable to be assessed in large clinical trials aimed at verifying the prevention of duodenal ulcer recurrence for longer periods.

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References

  1. Sontag SJ: Current status of maintenance therapy in peptic ulcer disease. Am J Gastroenterol 83:607–617, 1988

    Google Scholar 

  2. Bianchi Porro G, Parente F: Long term treatment of duodenal ulcer. A review of management options. Drugs 7:482–487, 1991

    Google Scholar 

  3. Jensen DM: Economic and health aspects of peptic ulcer disease and H2-receptor antagonists. Am J Med 81(suppl 4B):42–48, 1986

    Google Scholar 

  4. Lanzon Miller S, Pounder RE, Hamilton MR, Ball S, Chronos NAF, Raymond F, Olausson M, Cederberg C: Twenty-four-hour intragastric acidity and plasma gastrin concentration before and during treatment with either ranitidine and omeprazole. Aliment Pharmacol Ther 1:239–251, 1987

    Google Scholar 

  5. Maton PN: Omeprazole. N Engl J Med 324:965–975, 1991

    Google Scholar 

  6. Hewson EG, Yeomans ND, Angus PW, Shulkes A, Brook CW, Sewell RB, Smallwood RA: Effect of “weekend therapy” with omeprazole on basal and stimulated acid secretion and fasting plasma gastrin in duodenal ulcer patients. Gut 29:1715–1720, 1988

    Google Scholar 

  7. Baak LC, Jansen JBMJ, Biemond I, Lamers CBHW: Weekend treatment with 20 and 40 mg omeprazole: Effect on intragastric pH, fasting and postprandial serum gastrin, and serum pepsinogens. Gut 32:977–982, 1991

    Google Scholar 

  8. Lamberts R, Creutzfeldt Stockmann F, Jacubaschke U, Maas S, Brunner G: Long-term omeprazole treatment in man: Effects on gastric endocrine cell populations. Digestion 38:126–135, 1988

    Google Scholar 

  9. Solcia E, Rindi G, Havu N, Elm G: Qualitative studies of gastric endocrine cells in patients treated long-term with omeprazole. Scand J Gastroenterol 24(suppl 166):129–137, 1989

    Google Scholar 

  10. Dayal Y, Berlin R, Collen M, Bhatnager R: Does prolonged omeprazole administration affect enterochromaffin-like cell populations in hypersecretors? Gastroenterology 96:A113, 1989

  11. Lundell L, Backman L, Ekstrom P, Enander L-K, Falkner S, Fausa O, Grimelius L, Havu N, Lind T, Lonroth H, Sandmark S, Sandzen B, Unge P, Westin IH: Prevention of relapse of reflux oesophagitis after endoscopic healing: The efficacy and safety of omeprazole compared with ranitidine. Scand J Gastroenterol 26:248–256, 1991

    Google Scholar 

  12. Lind T, Cederberg C, Ekenved G, Haglund U, Olbe L: Effect of omeprazole—a gastric proton pump inhibitor—on pentagastrin stimulated acid secretion in man. Gut 24:270–276, 1983

    Google Scholar 

  13. Sharma BK, Walt RP, Pounder RE, Gomes MD, Wood EC, Logan RH: Optimal dose of oral omeprazole for maximal 24 hour decrease of intragastric acidity. Gut 25:957–964, 1984

    Google Scholar 

  14. Müller P, Dammann HG, Seitz H, Simon B: Effect of repeated, once daily, oral omeprazole on gastric secretion. Lancet 1:66, 1983

    Google Scholar 

  15. Savarino V, Mela GS, Scalabrini P, Magnolia MR, Percario G, Di Timoteo E, Celle G: 24 hour comparison between pH values of continuous intraluminal recording and simultaneous gastric aspiration. Scand J Gastroenterol 22:135–140, 1987

    Google Scholar 

  16. Savarino V, Mela GS, Zentilin P, Magnolia MR, Scalabrini P, Valle F, Moretti M, Bonifacino G, Celle G: Gastric aspiration versus antimony and glass pH electrodes. A simultaneous comparativein vivo study. Scand J Gastroenterol 24:434–439, 1989

    Google Scholar 

  17. Mela GS, Savarino V, Moretti M, Sumberaz A, Bonifacino G, Zentilin P, Caputo E, Villa G, Celle G: Antimony and glass pH electrodes can be used interchangeability in 24-hour studies of gastric acidity. Dig Dis Sci 36:1473–1481, 1990

    Google Scholar 

  18. Savarino V, Mela GS, Scalabrini P, Magnolia MR, Di Timoteo E, Percario G, Celle G: Continuous intragastric pH monitoring: Focus on its reproducibility in duodenal ulcer patients. A preliminary report. Gastroenterol Clin Biol 10:826–830, 1986

    Google Scholar 

  19. Mela GS, Savarino V, Moretti M, Bonifacino G, Sumberaz A, Zentilin P: Clinical relevance of sampling rate in the characterization and analysis of 24-hour gastric acidity. A report on 413 cases. Scand J Gastroenterol 24:683–687, 1989

    Google Scholar 

  20. Mela GS, Savarino V, Sumberaz A, Bonifacino G, Zentilin P, Villa G, Caputo E: Continuous acidity monitoring in the study of gastric antisecretory drugs: pH or antilog transformation of pH, mean or median? Am J Gastroenterol 85:1105–1108, 1990

    Google Scholar 

  21. Mela GS, Savarino V: Relationship between ulcer healing and acid suppression. Gastroenterology 100:1482–1483, 1991

    Google Scholar 

  22. Savarino V, Mela GS, Zentilin P, Bonifacino G, Moretti M, Valle F, Celle G: Low bedtime doses of H2-receptor antagonists for acute treatment of duodenal ulcer. Dig Dis Sci 34:1043–1046, 1989

    Google Scholar 

  23. Howden CW, Derodra JK, Burget DW, Hunt RH: Effects of low dose omeprazole on gastric secretion and plasma gastrin in patients with healed duodenal ulcer. Hepato-Gastroenterol 33:267–270, 1986

    Google Scholar 

  24. Hemery P, Galmiche JP, Roze C, Isal J-P, Bruley des Varennes S, Lavignolle A, Le Bodic L: Low dose omeprazole effects on gastric acid secretion in normal man. Gastroenterol Clin Biol 11:148–153, 1987

    Google Scholar 

  25. Lauritsen K, Andersen BN, Laursen LS, Hansen J, Havelund T, Eriksen J, Rehfeld JF, Kjaergaard J, Rask-Madsen J: Omeprazole 20 mg three days a week and 10 mg daily in prevention of duodenal ulcer relapse. Double-blind comparative trial. Gastroenterology 100:663–669, 1991

    Google Scholar 

  26. McTavish D, Buckley MM-T, Heel RC: Omeprazole. An updated review of its pharmacology and therapeutic use in acid-related disorders. Drugs 42:138–170, 1991

    Google Scholar 

  27. Savarino V, Mela GS, Zentilin P, Cutela P, Mele MR, Vigneri S, Celle G: Variability in individual response to various doses of omeprazole: Implications for antiulcer therapy. Dig Dis Sci (in press)

  28. Lind T, Cederberg C, Forssell H, Olausson M, Olbe L: Relationship between reduction of gastric acid secretion and plasma gastrin concentration during omeprazole treatment. Scand J Gastroenterol 23:1259–1266, 1988

    Google Scholar 

  29. Savarino V, Mela GS, Zentilin P, Celle G: Ulcer healing: does omeprazole efficacy depend on daytime or 24-hour acid inhibition? Gastroenterology 99:1858–1860, 1990

    Google Scholar 

  30. Hunt RH: The protective role of gastric acid. Scand J Gastroenterol 23(suppl 146):34–39, 1988

    Google Scholar 

  31. Freston JW: Clinical significance of hypergastrinemia: Relevance to gastrin monitoring during omeprazole therapy. Digestion 51(suppl 1):102–114, 1992

    Google Scholar 

  32. Penston JG, Wormsley KG: Review article: Maintenance treatment with H2-receptor antagonists for peptic ulcer disease. Aliment Pharmacol Ther 6:3–29, 1992

    Google Scholar 

  33. Penston JG, Wormsley KG: Nine years of maintenance treatment with ranitidine for patients with duodenal ulcer disease. Aliment Pharmacol Ther 6:629–645, 1992

    Google Scholar 

  34. Howden CW: Maintenance treatment with H2 receptor antagonists in patients with peptic ulcer disease: Rarely justified in terms of cost or patient benefit. Br Med J 297:1393–1394, 1988

    Google Scholar 

  35. Bardhan KD, Hollander D, Festen HPM, Bianchi Porro G: Changing strategies for peptic ulcer disease. Gastroenterol Int 3:3–21, 1990

    Google Scholar 

  36. Smith JTL, Gavey C, Nwokolo CU, Pounder RE: Tolerance during 8 days of high-dose H2-blockade: Placebo-controlled studies of 24-h acidity and gastrin. Aliment Pharmacol Ther 4S:47–64, 1990

    Google Scholar 

  37. Wilder-Smith CH, Ernst T, Gennoni M, Zeyen B, Halter F, Merki HS: Tolerance to oral H2-receptor antagonists. Dig Dis Sci 35:976–983, 1990

    Google Scholar 

  38. Rauws EAJ, Tytgat GNJ: Cure of duodenal ulcer associated with eradication ofHelicobacter pylori. Lancet 2:1233–1235, 1990

    Google Scholar 

  39. Peterson WL:Helicobacter pylori and peptic ulcer disease. N Engl J Med 324:1043–1048, 1991

    Google Scholar 

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Authors and Affiliations

  1. Clinica Medica R, Università Degli Studi di Genova, Italy

    Vincenzo Savarino MD, Giuseppe Sandro Mela MD, Patrizia Zentilin MD, Patrizia Cutela MD, Maria Raffaella Mele MD, Daniele Perilli MD, Ambrogio Vassallo MD, Adriana Zambotti MD, Carlo Mansi MD & Guido Celle MD

  2. DIMI, Cattedra di Gastroenterologia, Università di Genova, Viale Benedetto XV, n 6, 6132, Genova, Italy

    Vincenzo Savarino MD, Giuseppe Sandro Mela MD, Patrizia Zentilin MD, Patrizia Cutela MD, Maria Raffaella Mele MD, Daniele Perilli MD, Ambrogio Vassallo MD, Adriana Zambotti MD, Carlo Mansi MD & Guido Celle MD

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  1. Vincenzo Savarino MD
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  2. Giuseppe Sandro Mela MD
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  3. Patrizia Zentilin MD
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  4. Patrizia Cutela MD
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  5. Maria Raffaella Mele MD
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  10. Guido Celle MD
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Savarino, V., Mela, G.S., Zentilin, P. et al. Antisecretory effects of three omeprazole regimens for maintenance treatment in duodenal ulcer. Digest Dis Sci 39, 1473–1482 (1994). https://doi.org/10.1007/BF02088051

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  • DOI: https://doi.org/10.1007/BF02088051

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