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Overlapping approach proton pump inhibitors/Nux vomica-Heel as new intervention for gastro-esophageal reflux management:Delphi consensus study

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World Journal of Gastroenterology 2024年第18期30卷 2467-2478页

作者： Edda Battaglia Luciano Bertolusso Marco Del Prete Marco Monzani Marco Astegiano Gastroenterology Unit ASLTO4Ivrea 10015TurinItaly General Practitioner ASL CN2Alba-Bra 12051CuneoItaly Specialist in Nephrology International Academy of Physiological Regulating Medicine Milan 20100Italy Specialist in Endocrinology Territorial Social and Health Authority of BrianzaMonza 20900Italy Gastroenterology Specialist Retired from Gastroenterology and Hepatology UnitAOU Cittàdella Salute e della ScienzaTurin 10123Italy

BACKGROUND Gastro-esophageal reflux disease(GERD)may affect the upper digestive tract;up to 20%of population in Western nations are affected by ***,histamine H2-receptor antagonists,and proton pump inhibitors(PPIs)are considered the referring medications for ***,PPIs must be managed carefully because their use,especially chronic,could be linked with some adverse *** effective and safe alternative pharmacological tool for GERD is *** the identification of potentially new medications to flank PPIs,it is mandatory to revise and improve good clinical practices even through a consensus *** To optimize diagnosis and treatment guidelines for GERD through a consensus based on Delphi *** The availability of clinical studies describing the action of the multicomponent/multitarget medication Nux vomica-Heel,subject of the consensus,is the basic prerequisite for the consensus itself.A modified Delphi process was used to reach a consensus among a panel of Italian GERD specialists on the overlapping approach PPIs/Nux vomica-Heel as a new intervention model for the management of *** Voting Consensus group was composed of 49 Italian Medical Doctors with different specializations:Gastroenterology,otolaryngology,geriatrics,and general medicine.A scientific committee analyzed the literature,determined areas that required investigation(in agreement with the multiple-choice questionnaire results),and identified two topics of interest:(1)GERD disease;and(2)GERD *** for each of these topics were then formulated and *** Delphi process involved two rounds of questioning submitted to the panel experts using an online *** According to their routinary GERD practice and current clinical evidence,the panel members provided feedback to each questionnaire *** experts evaluated 15 statements and reached consensus on all *** statements regarding the GERD disease showed high levels of

关键词： Gastro-esophageal reflux disease proton pump inhibitors Consensus Nux vomica-Heel Overlapping Decalage

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proton pump inhibitors and gastroprotection in patients treated with antithrombotic drugs: A cardiologic point of view

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世界心脏病学杂志:英文版(电子版) 2023年第8期15卷 375-394页

作者： Maurizio Giuseppe Abrignani Alberto Lombardo Annabella Braschi Nicolo Renda Vincenzo Abrignani Operative Unit of Cardiology P.Borsellino HospitalASP TrapaniMarsala 91025TrapaniItaly Operative Unit of Cardiology S.Antonio Abate HospitalASP TrapaniErice 91100TrapaniItaly Department of Psychology Educational Science and Human MovementUniversity of PalermoPalermo 90100Italy Department of Direction CTA SalusGibellina 91024TrapaniItaly Operative Unit of Internal Medicine with Stroke Care Department of Health PromotionMother and Child CareInternal Medicine and Medical Specialties(ProMISE)“G.D’Alessandro”University of PalermoPalermo 90100Italy

Aspirin,other antiplatelet agents,and anticoagulant drugs are used across a wide spectrum of cardiovascular and cerebrovascular diseases.A concomitant proton pump inhibitor(PPI)treatment is often prescribed in these patients,as gastrointestinal complications are relatively *** the other hand,a potential increased risk of cardiovascular events has been suggested in patients treated with PPIs;in particular,it has been discussed whether these drugs may reduce the cardiovascular protection of clopidogrel,due to pharmacodynamic and pharmacokinetic interactions through hepatic ***,the concomitant use of clopidogrel and omeprazole or esomeprazole has been *** contrast,it remains less known whether PPI use may affect the clinical efficacy of ticagrelor and prasugrel,new P2Y12 receptor *** guidelines recommend PPI use in combination with antiplatelet treatment in patients with risk factors for gastrointestinal bleeding,including advanced age,concurrent use of anticoagulants,steroids,or non-steroidal anti-inflammatory drugs,and Helicobacter pylori(***)*** patients taking oral anticoagulant with risk factors for gastrointestinal bleeding,PPIs could be recommended,even if their usefulness deserves further *** infection should always be investigated and treated in patients with a history of peptic ulcer disease(with or without complication)treated with antithrombotic *** present review summarizes the current knowledge regarding the widespread combined use of platelet inhibitors,anticoagulants,and PPIs,discussing consequent clinical implications.

关键词： Antithrombotic drugs Anticoagulants Aspirin Clopidogrel Gastrointestinal bleeding proton pump inhibitors

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Exposure to proton pump inhibitors and risk of diabetes:A systematic review and meta-analysis

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World Journal of Diabetes 2023年第2期14卷 120-129页

作者： Yun-Ran Guo Xin-Ming Liu Gui-Xia Wang Department of Endocrinology and Metabolism The First Hospital of Jilin UniversityChangchun 130000Jilin ProvinceChina

BACKGROUND Exposure to proton pump inhibitors(PPIs)has been reported to have a potential role in the development of *** To determine the association between PPIs and *** This meta-analysis is registered on PROSPERO(CRD42022352704).In August 2022,eligible studies were identified through a comprehensive literature *** this study,odds ratios were combined with 95%confidence intervals using a random-effects *** source of heterogeneity was assessed using sensitivity analysis and subgroup *** publication bias was evaluated using Egger’s test and Begg’s *** The meta-analysis included 9 studies with a total of 867185 *** showed that the use of PPIs increased the risk of diabetes(odds ratio=1.23,95%confidence interval:1.05-1.43,n=9,I2=96.3%).Subgroup analysis showed that geographic location and study type had significant effects on the overall *** Egger’s and Begg’s tests showed no publication bias(P>0.05).Sensitivity analysis also confirmed the stability of the *** The results of this study indicated that the use of PPIs was related to an increased risk of ***,more well-designed studies are needed to verify these results in the future.

关键词： proton pump inhibitors Diabetes mellitus Odds ratio Meta-analysis Diabetogenesis

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Effects of postoperative use of proton pump inhibitors on gastrointestinal bleeding after endoscopic variceal treatment during hospitalization

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World Journal of Gastrointestinal Surgery 2023年第1期15卷 82-93页

作者： Yi-Yan Zhang Le Wang Xiao-Dong Shao Yong-Guo Zhang Shao-Ze Ma Meng-Yuan Peng Shi-Xue Xu Yue Yin Xiao-Zhong Guo Xing-Shun Qi Liver Cirrhosis Study Group Department of GastroenterologyGeneral Hospital of Northern Theater CommandShenyang 110840Liaoning ProvinceChina Postgraduate College China Medical UniversityShenyang 110122Liaoning ProvinceChina Postgraduate College Dalian Medical UniversityDalian 116044Liaoning ProvinceChina

BACKGROUND Endoscopic variceal treatment(EVT)is recommended as the mainstay choice for the management of high-risk gastroesophageal varices and acute variceal bleeding in liver *** pump inhibitors(PPIs)are widely used for various gastric acid-related ***,the effects of PPIs on the development of post-EVT complications,especially gastrointestinal bleeding(GIB),remain *** To evaluate the effects of postoperative use of PPIs on post-EVT complications in patients with liver cirrhosis during *** Patients with a diagnosis of liver cirrhosis who were admitted to the Department of Gastroenterology of the General Hospital of Northern Theater Command,treated by an attending physician between January 2016 and June 2020 and underwent EVT during their hospitalization were *** regression analyses were performed to explore the effects of postoperative use of PPIs on the development of post-EVT complications during *** ratios(ORs)with 95%confidence intervals(CIs)were *** A total of 143 patients were *** incidence of post-EVT GIB and other post-EVT complications was 4.90%and 46.85%,*** the overall analyses,postoperative use of PPIs did not significantly reduce the risk of post-EVT GIB(OR=0.525,95%CI=0.113-2.438,P=0.411)or other post-EVT complications(OR=0.804,95%CI=0.413-1.565,P=0.522).In the subgroup analyses according to the enrollment period,type and route of PPIs after the index EVT,use of PPIs before the index EVT,use of vasoactive drugs after the index EVT,indication of EVT(prophylactic and therapeutic),and presence of portal venous system thrombosis,ascites,and hepatocellular carcinoma,the effects of postoperative use of PPIs on the risk of post-EVT GIB or other post-EVT complications remain not statistically *** Routine use of PPIs after EVT should not be recommended in patients with liver cirrhosis for the prevention of post-EVT c

关键词： Endoscopic variceal treatment Gastrointestinal bleeding proton pump inhibitors Complications Liver cirrhosis Acute variceal bleeding

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proton pump inhibitors as a risk factor for recurrence of Clostridium-difficile-associated diarrhea

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World Journal of Gastroenterology 2010年第28期16卷 3573-3577页

作者： Ji Won Kim Kook Lae Lee Ji Bong Jeong Byeong Gwan Kim Sue Shin Joo Sung Kim Hyun Chae Jung In Sung Song Division of Gastroenterology and Hepatology Department of Internal MedicineSeoul National University Boramae Hospital Seoul National University College of Medicine Seoul 156-707South Korea Department of Laboratory Medicine Seoul National University Boramae Hospital Division of Gastroenterology and Hepatology Department of Internal MedicineSeoul National University Hospital Seoul National University College of Medicine Seoul 110-744South Korea

AIM:To investigate the risk factors for Clostridiumdifficile-associated diarrhea(CDAD)recurrence,and its relationship with proton pump inhibitors(PPIs). METHODS:Retrospective data of 125 consecutive hospitalized patients diagnosed with CDAD between January 2006 and December 2007 were collected by medical chart *** data included patient characteristics at baseline,underlying medical disease, antibiotic history before receiving a diagnosis of CDAD, duration of hospital stay,severity of CDAD,concurrenttreatment with PPIs,laboratory parameters,response to CDAD therapy,and recurrence of disease within 90 d of successful *** clinical and laboratory parameters were compared in patients in whom CDAD did or did not recur. RESULTS:Of the 125 patients(mean age,67.6± 13.9 years)that developed CDAD,98(78.4%)did not experience recurrence(non-recurrent group)and 27 (21.6%)experienced one or more recurrences(recurrent group).Prior to the development of CDAD,96% of the 125 patients were prescribed antibiotics,and 56(44.8%)of the patients received *** older than 65 years(P=0.021),feeding via nasogastric tube(NGT)(P=0.045),low serum albumin level(P =0.025),and concurrent use of PPIs(P=0.014) were found to be risk factors for CDAD recurrence by univariate ***,sex,length of hospital stay,duration and type of antibiotics used,severity of disease,leukocyte count and C-reactive protein(CRP) were not associated with risk of CDAD *** multivariate analysis,the important risk factors were advanced age(>65 years,adjusted OR:1.32,95% CI:1.12-3.87,P=0.031),low serum albumin level(< 2.5 g/dL,adjusted OR:1.85,95%CI:1.35-4.91,P= 0.028),and concurrent use of PPIs(adjusted OR:3.48, 95%CI:1.64-7.69,P=0.016). CONCLUSION:Advanced age,serum albumin level< 2.5 g/dL,and concomitant use of PPIs were found to be significant risk factors for CDAD recurrence.

关键词： Clostridium difficile Diarrhea Recurrence Risk factors proton pump inhibitors

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High-dose vs low-dose proton pump inhibitors for upper gastrointestinal bleeding:A meta-analysis

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World Journal of Gastroenterology 2010年第20期16卷 2558-2565页

作者： Wu, Liu-Cheng Cao, Yun-Fei Huang, Jia-Hao Liao, Cun Gao, Feng Guangxi Med Univ Dept Colorectal & Anal Surg Affiliated Hosp 1 Nanning 530021 Guangxi Zhuang Peoples R China

AIM:To evaluate the efficacy of high-dose proton pump inhibitors(PPIs)vs low-dose PPIs for patients with upper gastrointestinal ***:PubMed,Embase,the Cochrane Library,and Web of Science were searched to identify relevant randomized controlled trials(RCTs).Eligible trials were RCTs that compared high-dose PPI with low-dose PPI following endoscopic *** primary endpoint was rebleeding;secondary endpoints were patient numbers that needed surgery,and *** meta-analysis was performed with a fixed effects model or random effects ***:Nine eligible RCTs including 1342 patients were *** results showed that high-dose intravenous PPI was not superior to low-dose intra-venous PPI in reducing rebleeding[odds ratio(OR)= 1.091,95%confidential interval(CI):0.777-1.532],need for surgery(OR=1.522,95%CI:0.643-3.605) and mortality(OR=1.022,95%CI:0.476-2.196).Subgroup analysis according to different region revealed no difference in rebleeding rate between Asian patients(OR=0.831,95%CI,0.467-1.480)and European patients(OR=1.263,95%CI:0.827-1.929).CONCLUSION:Low-dose intravenous PPI can achieve the same efficacy as high-dose PPI following endoscopic hemostasis.

关键词： Meta-analysis High-dose Low-dose proton pump inhibitors Gastrointestinal bleeding

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Progress in the Study of Vonoprazan Fumarate vs. proton pump inhibitors in the Treatment of Gastroesophageal Reflux Disease

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Yangtze Medicine 2023年第2期7卷 95-104页

作者： Yuanmei Dai Baofeng Liu Xiaohui Shen Lei Huang The First Clinical College Changzhi Medical College Changzhi China Department of Endoscopy Heji Hospital Changzhi Medical College Changzhi China

Gastroesophageal reflux disease (GERD) is a common gastrointestinal disease, and proton pump inhibitors (PPIs) have been recommended as the first-line treatment for GERD. In recent years, studies on vonoprazan fumarate in the treatment of GERD have attracted widespread attention. In this paper, we review the research progress of vonoprazan fumarate and proton pump inhibitors in the treatment of GERD in recent years, and compare and analyze the efficacy, safety, tolerability, and advantages and disadvantages of long-term application of both. By reviewing the relevant literature, we found that vonoprazan fumarate has similar performance with proton pump inhibitors in terms of efficacy and safety, but has potential advantages in terms of tolerability and long-term application. Therefore, we believe that vonoprazan fumarate may become a new option for GERD treatment, helping clinicians to develop more appropriate treatment plans for patients and providing new ideas and directions for research in related fields.

关键词： Vonoprazan Fumarate proton pump inhibitors Gastroesophageal Reflux Disease Efficacy Safety Tolerability Long-Term Application

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Sporadic fundic gland polyps are not associated with proton pump inhibitors therapy but negatively correlate with Helicobacter pylori infection in China

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Chinese Medical Journal 2014年第7期127卷 1239-1243页

作者： Cao Hailong Qu Rui Zhang Zhihua Kong Xinyue Wang Shan Jiang Kui Wang Bangmao Department of Gastroenterology and Hepatology Tianjin General Hospital Tianjin Medical University Tianjin 300052 China Department of Gastroenterology and Hepatology Dongying People's Hospital Dongying Shandong 257091 China Department of Epidemiology Anhui Medical University HefeiAnhui 230032 China

Background Sporadic fundic gland polyps （FGPs） are common gastric *** studies reported that FGPs dramatically increased due to proton pump inhibitors （PPIs） use and a decreased prevalence of Helicobacter pylori （***） infection in Western ***,data are still *** study aimed to identify the relationships between these two factors and FGPs in *** Consecutive patients with FGPs detected were retrospectively *** including patients＇ age,sex,symptoms,*** infection,history of PPIs use,and the polyps were *** patient was compared with two randomly selected age-and sex-matched controls with similar symptoms in the same *** During the period from March 2011 to March 2012,a total of 328 patients were diagnosed as FGPs in 23 047 patients who underwent routine esophagogastroduodenoscopy and 656 patients without FGPs as *** mean age was （55.12±12.61） years,and 75.91％ were *** prevalence of *** in patients with FGPs was significantly lower than in those without FGPs （22.30％（64/287） vs.42.26％（224/530）,P ＜0.001,OR 0.392,95％ Cl 0.283-0.544）.Overall,a total of 54 patients with FGPs （54/328,16.46％） and 136 patients without FGPs （136/656,20.73％） received PPIs therapy （P=0.110）.According to the different duration of PPIs use,no significant differences of PPIs use were found between the cases and controls among all ***,the PPIs use was also similar,regardless of age,sex,*** infection,and the number of *** Sporadic FGPs may not be induced by PPIs therapy but negatively correlate with *** infection in China,which is not the same with the data in Western countries.

关键词： fundic gland polyps proton pump inhibitors Helicobacter pylori esophagogastroduodenoscopy

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Impact of Drug-Drug Interaction between CDK4/6 inhibitors and proton pump inhibitors on Survival Outcomes in the Treatment of Metastatic Breast Cancer—Real World Data from a Portuguese Center

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Journal of Cancer Therapy 2022年第5期13卷 266-274页

作者： Joana Reis Inês Costa Mariana Costa Ana Valente Catarina Almeida Marta Freitas Cláudia Caeiro Catarina Fernandes Nuno Tavares Miguel Barbosa Centro Hospitalar SÃ O JOÃ O E.P.E. Porto Portugal

Introduction: proton pump inhibitors (PPi) are widely prescribed, including in patients undergoing treatment for advanced breast cancer (ABC). Due to the pharmacokinetic characteristics of the CDK4/6 inhibitor (Ci) palbociclib a drug interaction with PPi was hypothesized. It was shown in a retrospective study that this association was an independent predictive factor for worse progression-free survival (PFS). Objective: To verify the impact of concomitant administration of PPi with Ci on overall survival (OS) and PFS. Material and Methods: This is a retrospective cohort study of patients treated with Ci for HR+HER2-ABC in the period from Feb/2017 to Aug/2020. SPSS software was used for data processing. Univariate analysis was done by the Kaplan-Meier method and log-rank test, and multivariate analysis by COX regression. P-value < 0.05 was considered significant. Results: 80 patients were included. The median age at diagnosis of ABC was 56 years (25 - 75). Treatment with Ci was 1st line for ABC in 68.8%. Choice of Ci was palbociclib in 73.8% (n = 59) and ribociclib in 26.3% (n = 21). The hormone partner was a nonsteroidal aromatase inhibitor in 45.0%, and fulvestrant in 55.0% of cases. 37.5% of patients were on PPi, and 70.0% of them were during the entire treatment (23.3% omeprazole, 73.4% pantoprazole, 3.3% others). Patients taking concomitant PPi and Ci had lower OS (OS-3 years 42.6% vs. 63.4%, p = 0.254) and PFS (PFS med 15 m. vs. 21 m., p = 0.733), although with no statistically significant difference. Discussion: In the sample, there was a numerical difference, without the statistical significance in the use of PPi in the survival of patients under Ci. This difference could be more evident with a longer follow-up and a larger sample size. This study intends to alert to the growing importance of checking for drug interactions. Polymedication, advanced age and the presence of several comorbidities are real problems in patients with ABC. Conclusion: Real-world dat

关键词： Drug Interaction Survival Impact Advanced Breast Cancer CDK4/6 inhibitors proton pump inhibitors

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Hypomagnesaemia associated with long-term use of proton pump inhibitors

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Gastroenterology Report 2015年第3期3卷 243-253页

作者： James Wei Tatt Toh Evonne Ong Robert Wilson General Surgery Liverpool HospitalUniversity of New South WalesLiverpoolNew South WalesAustralia University of New South Wales Clinical School LiverpoolNew South WalesAustralia Upper Gastrointestinal Surgery Liverpool HospitalUniversity of New South WalesLiverpoolNew South WalesAustralia

Hypomagnesaemia and associated hypocalcaemia and hypoparathyroidism have been increasingly recognised as rare longterm side-effects of proton pump inhibitors(PPIs).The PPIs may inhibit active magnesium(Mg)absorption by interfering with transcellular transient receptor potential melastatin-6 and-7(TRPM 6 and 7)*** recent cell culture studies have suggested concomitant inhibition of passive Mg absorption by *** being treated with a range of PPIs,the four patients in our case series developed hypomagnesaemia,which responded to withdrawal of therapy and initiation of Mg *** clinical course and management demonstrate key aspects of hypomagnesaemia associated with long-term use of PPIs.

关键词： proton pump inhibitors hypomagnesaemia hypocalcaemia.

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