TITLE

Which Dyspepsia Patients Will Benefit From Omeprazole Treatment?

AUTHOR(S)
Meineche-Schmidt, Villy; Christensen, Erik
PUB. DATE
October 2000
SOURCE
American Journal of Gastroenterology;Oct2000, Vol. 95 Issue 10, p2777
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
OBJECTIVE: The effect of omeprazole therapy in dyspepsia is unpredictable. The aim of this study was to identify patient characteristics and symptoms associated with the omeprazole response to improve selection of patients for empirical treatment with omeprazole. METHODS: Data from a randomized controlled trial of 471 patients with ulcer-like or reflux-like dyspepsia treated with omeprazole 20 mg daily (243 patients) or placebo (228 patients) for 2 wk were studied using logistic regression analysis. The patients were randomly divided into a model sample (N = 236) for modeling the association between the omeprazole response and descriptive variables, and a test sample (N = 235) for testing the obtained model. RESULTS: In the model sample a high body mass index, the use of antacids or H2-blockers within the last month, or pain at night time were independently associated with a good omeprazole response, whereas the presence of nausea was associated with a poor omeprazole response. Using these variables combined into a therapeutic index, the independent test sample patients could be classified into predicted good (N = 56), medium (N = 88), and poor omeprazole responders (N = 91). In these groups the observed therapeutic gain of omeprazole (omeprazole response minus placebo response) was 39.4%, 19.3%, and 4.6%, respectively (p = 0.013). For clinical use, an easy-to-use pocket chart to obtain the therapeutic index in a given patient has been devised. CONCLUSIONS: In dyspepsia the identification of potential responders to omeprazole can be improved by considering certain patient characteristics and symptoms associated with the omeprazole response. Applying these data using a simple pocket chart may assist decision about empirical omeprazole therapy in patients with dyspepsia in general practice.
ACCESSION #
17623966

 

Related Articles

  • Second-line and Rescue Therapies for Helicobacter pylori Eradication in Clinical Practice. Zullo, Angelo; De Francesco, Vincenzo; Manes, Gianpiero; Scaccianoce, Giuseppe; Cristofari, Francesca; Hassan, Cesare // Journal of Gastrointestinal & Liver Diseases;Jun2010, Vol. 19 Issue 2, p131 

    Background & Aims. A levofloxacin-based triple therapy and a rifabutin-based regimen are advised as second-line and rescue therapies in the current Italian guidelines for H. pylori eradication. However, no data are available for the efficacy of these treatments in clinical practice. Methods. A...

  • Omeprazole and placebo have same long-term effect on dyspepsia. Lepsch, Mark; Strayer, Scott // Journal of Family Practice;Sep2003, Vol. 52 Issue 9, p687 

    The article presents a study which compared the effect of omeprazole and placebo on dyspepsia. Symptoms were relieved in about half of patients receiving omeprazole. However, treatment did not reduce the number of patients who would need endoscopy to investigate the cause of dyspepsia. The...

  • Omeprazole: superior symptom relief in dyspepsia.  // PharmacoEconomics & Outcomes News;9/10/2005, Issue 486, p13 

    Discusses research being done on the performance of omeprazole, ranitidine, cisapride and placebo in Helicobacter pylori negative, primary care patients with dyspepsia by N. Chiba, D. Armstrong, A. Barkun, A. Thomson, S. Smyth, S. Escobedo, J. Lee, P. Sinclair and S. J. O. Veldhuyzen Van Zanten,...

  • Omeprazole. Friedman, G. // American Journal of Gastroenterology;Mar1987, Vol. 82 Issue 3, p188 

    Presents information on omeprazole, a substituted benzimidazoles which inhibits gastric acid secretion. Studies published relating to the efficacy of omeprazole; Overview of a clinical trial showing the efficacy of the drug on ulcer patients; Side effects and toxicity of omeprazole.

  • Barrett's Ulcer: Response to Standard Dose Ranitidine, High Dose Ranitidine, and Omeprazole. Lee, Frank I.; Isaacs, Peter E. T. // American Journal of Gastroenterology;Sep1988, Vol. 83 Issue 9, p914 

    Between January 1984 and December 1986, 116 patients were found to have columnar-lined esophagus (Barrett's esophagus) during upper gastrointestinal endoscopy. Twenty-eight patients (16 men and 12 women) were found to have peptic ulcer of the esophagus (Barrett's ulcer). In 17 (60%), standard...

  • Long-Term Omeprazole Is Safe and Efficacious. Brand, R. E.; Thompson, Jon S. // American Journal of Gastroenterology;Sep2000, Vol. 95 Issue 9, p2161 

    Presents an abstract of the study "Long-Term Omeprazole Treatment in Resistant Gastroesophageal Reflux Disease: Efficacy, Safety, and Influence of Gastric Mucosa," by E. Klinkenberg-Knol, F. Nelis J. Dent, et al, published in a 2000 issue of the "Gastroenterology."

  • Maintenance Therapy for Erosive Esophagitis in Children After Healing by Omeprazole: Is It Advisable? Boccia, Gabriella; Manguso, Francesco; Miele, Erasmo; Buonavolontà, Roberta; Staiano, Annamaria // American Journal of Gastroenterology;Jun2007, Vol. 102 Issue 6, p1291 

    OBJECTIVES: To evaluate the efficacy of acid-suppressive maintenance therapy for gastroesophageal reflux disease (GERD) in children, after the healing of reflux esophagitis. METHODS: Forty-eight children (median age 105 months, range 32–170) with erosive reflux esophagitis were initially...

  • Omeprazole 20 mg equal to 40 mg for primary care acid-related dyspepsia. Meineche-Schmidt, V. // Journal of Family Practice;Nov2004, Vol. 53 Issue 11, p873 

    A randomized controlled trial was conducted by researchers in Denmark in order to determine whether administering 40 mg of omeprazole is more effective than 20 mg for primary care patients with dyspepsia. A common primary care strategy for patients with dyspepsia and no alarm symptoms is to...

  • Antisecretorv Effect of Three Premeal Doses of Cimetidine 400 mg versus a Single Morning Dose of Omepra/ole 20 mg: Pathophysiological Implications for Duodenal Ulcer Treatment. Savarino, Vincenzo; Mela, Giuseppe Sandro; Zentilin, Patricia; Cutela, Patricia; Mansi, Carlo; Vassallo, Ambrogio; Franceschi, Massimo; Mela, Maria Raffaella; Dallorto, Enza; Celle, Guido // American Journal of Gastroenterology;Jul1993, Vol. 88 Issue 7, p1088 

    The success of omeprazole in the healing of duodenal ulcer has been attributed to its profound and almost around-the-clock inhibition of acid, but the relevance of reducing meal-stimulated acid secretion exclusively has recently been emphasized in several clinical trials. For this reason, we...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics