Proton Pump Inhibitors - CME Conferences
Proton Pump Inhibitors - CME Conferences Proton Pump Inhibitors - CME Conferences
6 th Annual Primary Care Spring Conference Thursday, April 12, 2012 Proton Pump Inhibitors AGA Technical Review 2008 • Ample evidence that PPIs are more effective than H2RAs in patients with esophageal GERD syndromes • Data supporting PPI doses higher than standard are minimal • There is no evidence that adding a nocturnal dose of an H2RA to twice daily PPI therapy improves long-term efficacy • Gastroenterology 2008;135:1392-1413 Proton Pump Inhibitors • A Cochrane review of 134 treatment trials in 36,978 patients with esophagitis, concluded that PPIs exhibit a better healing effect and faster symptom relief then H2RAs which in turn are better than placebo • concluded that there is no major difference in efficacy among the currently available PPIs (esomeprazole, lansoprazole, omeprazole, pantoprazole, rabeprazole) • the gain achieved by doubling the standard dose of PPI therapy is modest. • Cochrane Database Syst Rev 2007;2:CD003244 Wayne Weart, Pharm D Cost Effective Rx
6 th Annual Primary Care Spring Conference Thursday, April 12, 2012 Esomeprazole Vs. Lansoprazole Treatment of Erosive Esophagitis at 8 weeks Number % Healed (intent to treat) Esomeprazole 40 mg 2624 92.6% Lansoprazole 30 mg 2617 88.8% (E 40 Vs L 30 ARR 3.8%, NNT-27) Am J Gastroenterol 2002; 97: 575-583 Consumer Reports Best Buy Drugs January 2007 • “Taking effectiveness, safety, and cost into account, we have chosen over-the-counter Prilosec OTC (omeprazole) 20mg as the Consumer Reports Best Buy Drug if you need a PPI.” • A comparison table from the Drug Effectiveness Review Project -Oregon Health Sciences University may be accessed at the link : www.ohsu.edu/ohsuedu/research/policycenter/DERP/about/finalproducts.cfm • Mc Donagh and Carson, Drug Class Review on Proton Pump Inhibitors, Final Report, July 2006 Wayne Weart, Pharm D Cost Effective Rx
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6 th Annual Primary Care Spring Conference Thursday, April 12, 2012<br />
Esomeprazole Vs. Lansoprazole<br />
Treatment of Erosive<br />
Esophagitis at 8 weeks<br />
Number<br />
% Healed<br />
(intent to treat)<br />
Esomeprazole 40 mg 2624 92.6%<br />
Lansoprazole 30 mg 2617 88.8%<br />
(E 40 Vs L 30 ARR 3.8%, NNT-27)<br />
Am J Gastroenterol 2002; 97: 575-583<br />
Consumer Reports Best Buy Drugs January<br />
2007<br />
• “Taking effectiveness, safety, and cost into account, we<br />
have chosen over-the-counter Prilosec OTC (omeprazole)<br />
20mg as the Consumer Reports Best Buy Drug if you need<br />
a PPI.”<br />
• A comparison table from the Drug Effectiveness Review<br />
Project -Oregon Health Sciences University may be<br />
accessed at the link :<br />
www.ohsu.edu/ohsuedu/research/policycenter/DERP/about/finalproducts.cfm<br />
• Mc Donagh and Carson, Drug Class Review on <strong>Proton</strong> <strong>Pump</strong><br />
<strong>Inhibitors</strong>, Final Report, July 2006<br />
Wayne Weart, Pharm D<br />
Cost Effective Rx
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