gastro-jРоссийский журнал гастроэнтерологии, гепатологии, колопроктологииRussian Journal of Gastroenterology, Hepatology, Coloproctology1382-43762658-6673«Gastro» LLC10.22416/1382-4376-2023-33-1-68-76gastro-j-770Research ArticleНАЦИОНАЛЬНАЯ ШКОЛА ГАСТРОЭНТЕРОЛОГИИ, ГЕПАТОЛОГИИNATIONAL COLLEGE OF GASTROENTEROLOGY, HEPATOLOGYКак безошибочно выбрать ингибитор протонной помпы у пациента с гастроэзофагеальной рефлюксной болезнью?How to Make the Right Choice of Proton Pump Inhibitor for Patients with Gastroesophageal Reflux Disease?https://orcid.org/0000-0003-0139-9773ЕвсютинаЮ. В.EvsyutinaYu. V.

Евсютина Юлия Викторовна — кандидат медицинских наук, магистр медицины, врач 

ул. Буньон 46, 1011, Швейцария, Лозанна

Yulia V. Evsyutina — Cand. Sci. (Med), master of medicine, physician of Centre hospitalier universitaire vaudois (CHUV)

Rue du Bugnon 46, 1011, Lausanne, Switzerland

evsyutina.yulia@gmail.comУниверситетский кантональный госпитальШвейцарияCentre hospitalier universitaire vaudoisSwitzerland2023230420233316876Copyright © Евсютина Ю.В., 20232023Евсютина Ю.В.Evsyutina Y.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gastro-j.ru/jour/article/view/770Цель исследования

Цель исследования: провести анализ основных фармакокинетических свойств ингибиторов протонной помпы (ИПП) и их значение в лечении гастроэзофагеальной рефлюксной болезни (ГЭРБ).

Основные положения

Основные положения. Пантопразол обладает высокой биодоступностью, абсолютная биодоступность пантопразола в дозе 40 мг составляет 77 % начиная с первого приема и не изменяется при повторном применении. Пантопразол демонстрирует более быстрое начало действия в сравнении с омепразолом. Одновременный прием пищи не изменяет биодоступность пантопразола. Подавление продукции соляной кислоты на фоне приема пантопразола сопровождается достижением эндоскопической ремиссии ГЭРБ к 28-му дню у 91 % пациентов с рефлюкс-эзофагитом и к 56-му дню — у всех пациентов в исследованиях «PANSTAR». Пантопразол в сравнении с другими ИПП оказывает незначительное влияние на CYP2C19, что минимизирует риск межлекарственных взаимодействий. Пантопразол — наиболее рН-селективный ИПП, что обусловливает специфичность действия только в париетальных клетках желудка и наибольшую безопасность длительного приема у пациентов с коморбидной патологией.

Заключение

Заключение. ИПП составляют основу терапии кислотозависимых заболеваний и, в частности, гастроэзофагеальной рефлюксной болезни. От других ИПП пантопразол отличает стойкая высокая биодоступность, продолжительный антисекреторный эффект, очень низкое сродство с цитохромом Р450.

Аim

Аim: to analyze the main pharmacokinetic properties of proton pump inhibitors (PPIs) and their significance in the treatment of gastroesophageal reflux disease (GERD).

Key points

Key points. Pantoprazole has a high bioavailability, the absolute bioavailability of pantoprazole at a dose of 40 mg is 77 % from the first dose and does not change with repeated use. Pantoprazole shows a faster onset of action than omeprazole. Simultaneous food intake does not change the bioavailability of pantoprazole. Suppression of hydrochloric acid production while taking pantoprazole accompanies by the achievement of endoscopic remission of GERD by day 28 in 91 % of patients with reflux esophagitis and by day 56 in all patients in the PANSTAR studies. Pantoprazole has little effect on CYP2C19 compared to other PPIs, minimizing the risk of drug-drug interactions. Pantoprazole is the most pH-selective PPI, which determines the specificity of action only in the parietal cells of the stomach and the greatest safety of long-term use in patients with comorbid pathology.

Conclusion

Conclusion. PPIs form the basis of the therapy of acid-dependent diseases, and, in particular, gastroesophageal reflux disease. Pantoprazole is distinguished from other PPIs by its persistent high bioavailability, long-term antisecretory effect, and very low affinity for cytochrome P450.

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The authors declare that there are no conflicts of interest present.