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Type: Journal article
Title: Long-term omeprazole treatment in resistant gastroesophageal reflux disease: Efficacy, safety, and influence on gastric mucosa
Author: Klinkenberg-Knol, E.
Nelis, F.
Dent, J.
Snel, P.
Mitchell, B.
Prichard, P.
Lloyd, D.
Havu, N.
Frame, M.
Roman, J.
Walan, A.
Citation: Gastroenterology, 2000; 118(4):661-669
Publisher: W B Saunders Co
Issue Date: 2000
ISSN: 0016-5085
Abstract: <h4>Background & aims</h4>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).<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>Long-term omeprazole therapy (up to 11 years) is highly effective and safe for control of reflux esophagitis.
Keywords: Long-Term Study Group; Gastric Mucosa; Humans; Helicobacter Infections; Barrett Esophagus; Gastroesophageal Reflux; Esophagitis; Gastritis; Hyperplasia; Omeprazole; Gastrins; Anti-Ulcer Agents; Treatment Outcome; Drug Resistance; Time Factors; Adolescent; Adult; Aged; Aged, 80 and over; Middle Aged; Child; Female; Male
RMID: 0001002065
DOI: 10.1016/S0016-5085(00)70135-1
Appears in Collections:Medicine publications

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