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Women with GERD can make do with lower PPI doses

20 Jun 2017

Female patients taking long-term proton pump inhibitors (PPIs) have threefold odds of tolerating half of their prior dose, suggesting that the female gender is associated with an increased probability for successful step-down, according to a recent study.

A double-blind randomized trial was conducted to determine the proportion of patients with gastro-oesophageal reflux disease (GERD) on PPI therapy who could reduce their prior dosage by half and to identify predictors of successful step-down.

Researchers randomly assigned a total of 100 patients with endoscopically verified erosive oesophagitis on long-term PPI therapy to either step down their dose by half (n=51; 25 females) or continue with the same dose for 8 weeks (n=49; 24 females). Fasting gastrin levels were measured before and after treatment. Successful step-down throughout the study period was the primary endpoint.

Female patients, compared with male patients, had higher gastrin levels (78 vs 50 pg/mL; p=0.007). Among the participants assigned to the step-down intervention, only 3/25 (12 percent) women did not complete the 2 months of lower-dose therapy vs 9/25 (36 percent) men (p=0.09).

The strongest predictor for successful step-down was female gender (odds ratio, 1.27; 95 percent CI, 1.01 to 1.60). The reduction group had a twofold chance of failure in maintaining symptom control as compared with the control group (24 vs 13 percent; p=0.2).

“These results indicate that women with gastro-oesophageal reflux disease might manage with lower doses of PPIs as compared with men,” researchers said.

Gastric acid inhibition leads to appropriate hypergastrinemia, and a gender difference has been shown in fasting gastrin, with greater levels observed among women than men on long-term PPI therapy, according to researchers.

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Most Read Articles
05 Aug 2017
Discontinuation of antihypertensive drugs appears to have a detrimental effect, with a recent study reporting that the risk of acute myocardial infarction (AMI) substantially increases after more than 90 days of discontinuation.
01 Sep 2016
Digoxin, as a new or preexisting therapy, does not increase mortality following acute phase of ST-elevation myocardial infarction (STEMI), as shown in the MAGIC study.
15 Apr 2016
Addition of digoxin to an ACE inhibitor lessens heart failure (HF) hospitalisation in HF patients with reduced ejection fraction, regardless of diabetes status, as presented in an analysis of the Digitalis Investigation Group trial.
03 Aug 2017
Cetuximab and docetaxel is safe and effective during postoperative radiotherapy for high-risk head and neck cancer patients who cannot receive cisplatin, a new study has found.