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one year ago
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Women with GERD can make do with lower PPI doses

5 days ago

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
one year ago
Immediate delivery at 36 weeks has shown to be an ideal delivery approach for women with intrahepatic cholestasis, according to a literature review.
6 months ago

Associate Professor Ng Lee Ching, Director of the Environmental Health Institute (EHI) at the National Environment Agency (NEA), Singapore, speaks about the role of primary care physicians and government agencies in preventing dengue epidemics.

3 days ago
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2 months ago
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