Deprescribing and Optimal Selection of Proton Pump Inhibitors (Contributions of the 26th United Russian Gastroenterology Week)
https://doi.org/10.22416/1382-4376-2020-30-6-7-18
Abstract
Aim. Presentation of the Forum “Deprescribing and optimal selection of proton pump inhibitors” held in Moscow on 29 September 2020 during the 26th United Russian Gastroenterology Week.
Key points. The Forum was aimed at discussing issues associated with improving the proton pump inhibitor (PPIs) therapy in treatment and prevention of acid-related diseases and upper gastrointestinal tract (GIT) disorders induced by non-steroidal anti-inflammatory drugs (NSAIDs) and antiplatelet medications. Deprescribing is considered to be an effective strategy of a motivated reduction of the PPI dosage, duration of therapy and the patient’s transfer from a regular to on-demand intake regimen. The choice of PPI may condition an optimal therapy for acid-related diseases.
Conclusion. PPIs prevail in therapies for acid-related diseases and NSAID-induced upper GIT lesions. PPI deprescribing should be a strategy of choice if medically indicated. A non-enzymatic metabolism, high acid suppression, stable antisecretory effect from day 1 of therapy and cytoprotective action justify the application of rabeprazole (Pariet®) for optimising therapies for acid-related diseases and implementing the deprescribing strategy.
About the Authors
V. T. IvashkinRussian Federation
Vladimir T. Ivashkin — Member of the Russian Academy of Sciences, Prof., Dr. Sci. (Med.), Head of the Chair of Internal Diseases Propedeutics, Gastroenterology and Hepatology, Sklifosovsky Institute of Clinical Medicine; Director, Vasilenko Clinic of Internal Diseases Propedeutics, Gastroenterology and Hepatology
19435, Moscow, Pogodinskaya str., 1, bld. 1
I. V. Maev
Russian Federation
Igor V. Maev — Member of the Russian Academy of Sciences, Prof., Dr. Sci. (Med.), Head of the Chair of Internal Medicine Propedeutics and Gastroenterology
127473, Moscow, Delegatskaya str., 20, bld. 1
A. S. Trukhmanov
Russian Federation
Alexander S. Trukhmanov — Dr. Sci. (Med.), Prof., Chair of Internal Diseases Propedeutics, Gastroenterology and Hepatology, Sklifosovsky Institute of Clinical Medicine
19435, Moscow, Pogodinskaya str., 1, bld. 1
A. A. Sheptulin
Russian Federation
Arkadiy A. Sheptulin — Dr. Sci. (Med.), Prof., Chair of Internal Diseases Propedeutics, Gastroenterology and Hepatology, Sklifosovsky Institute of Clinical Medicine
119435, Moscow, Pogodinskaya str., 1, bld. 1
V. I. Simanenkov
Russian Federation
Vladimir I. Simanenkov — Dr. Sci. (Med.), Prof., Chair of Internal Diseases, Clinical Pharmacology and Nephrology
191015, St.-Petersburg, Kirochnaya str., 41
T. L. Lapina
Russian Federation
Tatyana L. Lapina — Cand. Sci. (Med), Assoc. Prof., Chair of Internal Diseases Propedeutics, Gastroenterology and Hepatology, Sclifosovsky Institute of Clinical Medicine
119435, Moscow, Pogodinskaya str., 1, bld. 1
I. B. Khlynov
Russian Federation
Igor B. Khlynov — Dr. Sci. (Med.), Assoc. Prof., Chair of Intermediate Therapy and Geriatrics
620028, Ekaterinburg, Repina str., 3
N. N. Dekhnich
Russian Federation
Natalya N. Dekhnich — Cand. Sci. (Med.), Assoc. Prof., Department of Faculty Therapy; Researcher of Institution of Antimicrobial Chemotherapy
214019, Smolensk, Krupskaya str., 28
O. D. Lopina
Russian Federation
Olga D. Lopina — Dr. Sci (Biol.), Prof., Chair of Biochemistry, Biology Faculty
119234, Moscow, Leninskie gory, 1, bld. 12
O. P. Alekseeva
Russian Federation
Olga P. Alekseeva — Dr.Sci (Med.), Prof., Chair of Hospital Therapy and General Medical Practice named after V.G. Vogralik
603950, Nyzhny Novgorod , Minin and Pojharskiy sq., 10/1
N. V. Korochanskaya
Russian Federation
Natalia V. Korochanskaya — Dr. Sci. (Med.), Prof., Chair of Surgery № 1 with Course of Gastroenterology
350012, Krasnodar, Krasnykh Partisan str., 6, bld. 2
M. F. Osipenko
Russian Federation
Marina F. Osipenko — Dr. Sci. (Med.), Prof., Head of the Chair of Internal Diseases Propedeutics
630091, Novosibirsk, Krasnyi ave., 52
P. V. Pavlov
Russian Federation
Pavel V. Pavlov — Cand. Sci. (Med.), Chief of Endoscopy Unit in University Clinical Hospital № 2, Assoc. Prof., Chair of the Surgery, Sklifosovsky, Institute of Clinical Medicine
119435, Moscow, Pogodinskaya str., 1, bld. 1
S. S. Pirogov
Russian Federation
Sergei S. Pirogov — Dr. Sci. (Med.), Head of the Department of Endoscopy
125284, Moscow, Vtoroy Botkinskiy drive, 3
G. N. Tarasova
Russian Federation
Galina N. Tarasova — Dr.Sci. (Med.), Prof., Chair of Internal Disease Propedeutics
344022, Rostov-on-Don, Nakhichevan lane, 29
Yu. P. Uspenskiy
Russian Federation
Yury P. Uspenskiy — Dr. Sci. (Med.), Prof., Head of the Chair of Faculty Therapy named after V.A. Valdman, Saint-Petersburg State Pediatric Medical University
191014, St. Petersburg, Liteyniy ave., 56
D. N. Andreev
Russian Federation
Dmitrii N. Andreev — Cand. Sci. (Med.), Assoc. Prof., Chair of Internal Medicine Propaedeutics and Gastroenterology, Moscow State University of Medicine and Dentistry; Researcher, Laboratory of Functional Research in Gastroenterology
127473, Moscow, Delegatskaya str., 20, bld. 1
D. E. Rumyantseva
Russian Federation
Diana E. Rumyantseva — Cand. Sci. (Med.), Physician, Department of Gastroenterology, Vasilenko Clinic of Internal Diseases Propaedeutics, Gastroenterology and Hepatology
119435, Moscow, Pogodinskaya str., 1, bld. 1
References
1. Marelli S., Pace F. Rabeprazole for the treatment of acid-related disorders. Expert Rev Gastroent Hepatol. 2012;6(4):423–35. DOI: 10.1586/egh.12.18
2. Ivashkin V.T., Maev I.V., Trukhmanov A.S., Lapina T.L., Storonova O.A., et al. Recommendations of Russian Gastroenterological Association in diagnosis and treatment of gastroesophageal reflux desease. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2020;30(4):70–97 (In Russ.). DOI: 10.22416/1382-4376-2020-30-4-70-97
3. Kuo C.W., Wang S.S., Hsu W.H., Kuo F.C., Weng B.C, Li C.J., et al. Rabeprazole can overcome the impact of CYP2C19 polymorphism on quadruple therapy. Helicobacter. 2010;15(4):265–72. DOI: 10.1111/j.15235578.2010.00761.x
4. McNicholl A.G., Linares P.M., Nyssen O.P., Calvet X., Gispert J.P. Meta-analysis: esomeprazole or rabeprazole vs. first-generation pump inhibitors in the treatment of Helicobacter pylori infection. Aliment Pharmacol Ther. 2012;36(5):414–25. DOI: 10.1111/j.1365-2012.05211.x
5. Skoczylas T., Sarosiek I., Sostarich S., McElhinney C., Durham S., Sarosiek J. Significant enhancement of gastric mucin content after rabeprazole administration: its potential clinical significance in acid-related disorders. Dig Dis Sci. 2003;48(2):322–8. DOI: 10.1023/a:1021983611768
6. Guslandi M. Proton Pump Inhibitors and Mucus Secretion. Dig Dis Sci. 2010;55(1):217. DOI: 10.1007/s10620009-1028-5
7. Sarosiek I., Olyaee M., Majevski M., Sidorenko E. Roeser K., Wallner G., Sarosiek J. Significant increase of esophageal mucin secretion in patients with reflux esophagitis after healing with rabeprazole: its esophagoprotective potential. Dig Dis Sci. 2009;54:2137–42. DOI: 10.1007/s10620-008-0589-z
8. Weijenborg P.W., Cremonini F., Smout A.J., Bredenoord A.J. PPI therapy is equally effective in well-defined non-erosive reflux disease and in reflux esophagitis: a meta-analysis. Neurogastroenterol Motil. 2012;24(8):747–57, e350. DOI: 10.1111/j.1365-2982.2012.01888.x
9. Robinson M., Horn J. Clinical pharmacology of proton pump inhibitors: what the practising physician needs to know. Drugs. 2003;63(24):2739–54. DOI: 10.1111/j.13652036.2004.02160.x
10. Besancon M., Simon A., Sachs G., Shin J.M. Sites of reaction of the gastric H,K-ATPase with extracytoplasmic thiol reagents. J. Biol Chem. 1997;272:22438–46. DOI: 10.1074/jbc.272.36.22438
11. Kromer W. Relative efficacies of gastric proton-pump inhibitors on a milligram basis: desired and undesired SH reactions. Impact of chirality. Scand J Gastroenterol Suppl. 2001;(234):3–9. DOI: 10.1080/003655201753265389
12. Kromer W., Kruger U., Huber R., Hartmann M., Steinijans V.W. Differences in pH dependent activation rates of substituted benzimidazoles and control over acid secretion and onset of symptom biological in vitro correlates. Pharmacology. 1998;56:57–70. DOI: 10.1159/000028183
13. Pantoflickova D., Dorta G., Ravic M., Jornod P., Blum A.L. Acid inhibition on the first day of dosing: comparison of four proton pump inhibitors. Aliment Pharmacol Ther. 2003;17:1507–14. DOI: 10.1046/j.13652036.2003.01496.x
14. Horn J. Review article: understanding the pharmacodynamic and pharmacokinetic differences between proton pump inhibitors — focus on pKa and metabolism. Alimentary Pharmacology & Therapeutics Symposium Series. 2006;2:340–50. DOI: 10.1111/j.1746-6342.2006.00065.x
15. Dekkers C.P., Beker J.A., Thjodleifsson B., Gabryelewicz A., Bell N.E., Humphries T.J. Double-blind placebo controlled comparison of rabeprazole 20 mg vs. omeprazole 20 mg in the treatment of erosive or ulcerative gastro-oesophageal reflux disease. The European Rabeprazole Study Group. Aliment Pharmacol Ther. 1999;13(1):49–57. DOI: 10.1046/j.1365-2036.1999.00438.x
16. Kastelein F., Spander M.C., Steyerberg E.W., Biermann K., Valkhoff V.E., Kuipers E.J., Bruno M.J. Proton pump inhibitors reduce the risk of neoplastic progression in patients with Barrett’s esophagus. Clin Gastroenterol Hepatol. 2013;11(4):382–8. DOI: 10.1016/j.cgh.2012.11.014
17. Scally B., Emberson J.R., Spata E., Reith C., Davies K., Halls H., et al. Effects of gastroprotectant drugs for the prevention and treatment of peptic ulcer disease and its complications: a meta-analysis of randomized trials. Lancet Gastroenterol Hepatol. 2018;3(4):231–41. DOI: 10.1016/S2468-1253(18)30037-2
18. Jaworski T., Sarosiek I., Sostarich S., Roeser K., Connor M., Brotze S., et al. Restorative Impact of Rabeprazole on Gastric Mucus and Mucin Production Impairment During Naproxen Administration Its Potential Clinical Significance. Dig Dis Sci. 2005;50(2):357–65. DOI: 10.1007/s10620-005-1611-3
19. Shay H., Sun D.C.H. Etiology and pathology of gastric and duodenal ulcer. In: Bockus H.L. Gastroenterology, Philadelphia-London: Saunders Elsevier, 1968:420–65.
20. Al-Haddad S., Chang A.C., De Hertogh G., Grin A., Langer R., Sagaert X. et al. Infection and esophageal cancer. Ann NY Acad Sci. 2014;1325:187–6. DOI: 10.1111/nyas.12530
21. Snider E.K., Freedberg D.E., Abrams J.A. Potential role of the microbiome in Barrett’s esophagus and esophageal adenocarcinoma. Dig Dis Sci. 2016;61(8):2217–25. DOI: 10.1007/s10620-016-4155-9
22. Abreu M.T., Peek R.M. Gastrointestinal Malignancy and the Microbiome. Gastroenterology. 2014;146(6):1534–46. e3. DOI: 10.1053/j.gastro.2014.01.001
23. Vesper B.J., Jawdi A., Altman K.W., Haines G.K.III, Tao L., Radosevich J.A. The effect of proton pump inhibitors on the human microbiota. Curr Drug Metabol. 2009;10:84–9. DOI: 10.2174/138920
24. Rumyantseva D.Y., Trukhmanov A.S., Kudryavtseva A.V., Ivashkin V.T. Effect of antisecretory treatment on gastrointestinal microbiota. Rus J Gastroenterol Hepatol Coloproctol. 2018;28(1):78–88 (In Russ.). DOI: 10.22416/1382-43762018-28-1-78-88
25. Thompson W., Farrell B. Deprescribing: what is it and what does the evidence tell us? Can J Hosp Pharm. 2013;66(3):201–2. DOI: 10.4212/cjhp.v66i3.1261
26. Farrell B., Pottie K., Thompson W., Boghossian T., Pizzola L., Rashid F.J., et al. Deprescribing proton pump inhibitors: Evidence-based clinical practice guideline. Can Fam Phys. 2017;63(5):354–64.
27. Boghossian T.A., Rashid F.J., Thompson W., Welch V., Moayyeddi P., Rojas-Fernandez C., et al. Deprescribing versus continuation of chronic proton pump inhibitor use in adults. Cochrane Database Syst Rev. 2017;3(3):CD011969. DOI: 10.1002/14651858.CD011969
28. Simanenkov V.I., Tikhonov S.V., Lischuk N.B. Treatment compliance at initial and maintenance therapy at gastroesophageal reflux disease. Rus J Gastroenterol Hepatol Coloproctolo. 2017;27(1):29–34 (In Russ.). DOI: 10.22416/1382-4376-2017-27-1-29-34
29. Helgadottir H., Bjornsson E.S. Problems associated with deprescribing of proton pump inhibitors. Int J Mol Sci. 2019;20(21):5469. DOI: 10.3390/ijms20215469
30. Kinoshita Y., Ishimura N., Ishihara S. Advantages and disadvantages of long-term proton pump inhibitor use. J Neurogastroenterol Motil. 2018;24(2):182–96. DOI: 10.5056/jnm18001
31. Sibbing D., Morath T., Stegherr J., Braun S., Vogt W., Hadamitzky M., et al. Impact of proton pump inhibitors on the antiplatelet effects of clopidogrel. Thromb Haemost. 2009;101:714–9.
32. Sharara A., Malli A., El-Halabi M., Mansour N., Ghaith O., Harb R., et al. The Effect of CYP2C19 genetic polymorphisms and the concomitant use of rabeprazole or esomeprazole on the anti-platelet action of clopidogrel. Amer J Gastroenterol. 2011;106 (Suppl):S37–8.
33. Ahn J.H., Park Y., Bae J.S., Jang J.Y., Kim K.H., et al. Influence of rabeprazole and famotidine on pharmacodynamic profile of dual antiplatelet therapy in clopidogrel-sensitive patients: The randomized, prospective, PROTECT trial. Platelets. 2020;31(3):329–36. DOI: 10.1080/09537104.2019.1609667
34. Lodato F., Azzaroli F., Di Girolamo M., Feletti V., Cecinato P., Lisotti A.F., et al. Proton pump inhibitors in cirrhosis: Tradition or evidence based practice? World J Gastroenterol. 2008;14(19):2980–5. DOI: 10.3748/wjg.14.2980
35. Caos A., Breiter J., Perdomo C., Barth J. Long-term prevention of erosive or ulcerative gastro-oesophageal reflux disease relapse with rabeprazole 10 or 20 mg vs. placebo: results of a 5-year study in the United States. Aliment Pharmacol Ther. 2005;22(3):193–202. DOI: 10.1111/j.1365-2036.2005.02555.x
36. Vaezi N.F., Yang Y.X., Howden C.W. Complications of proton pump inhibitors. Gastroenterology. 2017;153(1):35–48. DOI: 10.1053/j.gastro.2017.04.04
37. Wang C.H., Li C.H., Hsieh R., Fan C.Y., Hsu T.C., Chang W.C., et al. Proton pump inhibitors therapy and the risk of pneumonia: a systemic review and meta-analysis of randomized controlled trials and observational studies. Expert Opin Drug Saf. 2019;18(3):163–72. DOI: 10.1080/14740338.2019.1577820
38. Batchelor R., Kumar R., Gilmartin-Thomas J.F.M., Hopper I., Kemp W., Liew D. Systemic review with meta-analysis: risk of adverse cardiovascular events with proton pump inhibitors independent of clopidogrel. Aliment Pharmacol Ther. 2018;48(8):780–96. DOI: 10.1111/apt.14955
39. Liao S., Gan L., Mei Z. Does the use of proton pump inhibitors increase the risk of hypomagnesemia? An update systematic review and meta-analysis. Medicine (Baltimore). 2019;98(13):e15011. DOI: 10.1097/MD.0000000000015011
40. McQuaid K.R., Laine L. Early heartburn relief with proton pump inhibitors: a systematic review and metaanalysis of clinical trials. Clin Gastroenterol Hepatol. 2005;3(6):553–63. DOI: 10.1016/S1542-3565(05)00023-6
41. Tang H.L., Li Y., Hu Y.F., Xie H.G., Zhai S.D. Effects of CYP2C19 loss-of-function variants on the eradication of
42. H. pylori infection in patients treated with proton pump inhibitor-based triple therapy regimens: a meta-analysis of randomized clinical trials. PLoS One. 2013;8:e62162. DOI: 10.1371/journal.pone.0062162
43. Yasuda S., Horai Y., Tomono Y., Nakai H., Yamato C., Manabe K., et al. Comparison of the kinetic disposition and metabolism of E3810, a new proton pump inhibitor, and omeprazole in relation to S-mephenytoin 4’-hydroxylation status. Clin Pharmacol Ther. 1995;58(1):43–154. DOI: 10.1016/0009-9236(95)90192-2
44. Tanaka M., Ohkubo T., Otani K., Suzuki A., Kaneko S., Sugawara K., et al. Metabolic disposition of pantoprazole, a proton pump inhibitor, in relation to S-mephenytoin 4’-hydroxylation phenotype and genotype. Clin Pharmacol Ther. 1997;62:619–28. DOI: 10.1016/S00099236(97)90081-3
45. Sohn D-R., Kwon J.T., Kim H. K., Ishizaki T. Metabolic disposition of lansoprazole in relation to the S-mephenytoin 4’-hydroxylation phenotype status. Clin Pharmacol Ther. 1997;61(5):574–82. DOI: 10.1016/S0009-9236(97)90137-5
46. Hughes D., Bodger, K., Bytzer P., de Herdt D., Dubois D. Economic analysis of on-demand maintenance therapy with proton pump inhibitors in patients with non-erosive reflux disease. Pharmacoeconomics. 2005;23(10):1031–41. DOI: 10.2165/00019053-200523100-00006
47. Watanabe T., Higuchi K., Tominaga K., Fujiwara Y., Arakawa T. Cytoprotective effect of rabeprazole against ethanol-induced gastric mucosal damage: possible involvement of nitric oxide: possible involvement of nitric oxide. Drug Exptl Clin Res. 2000;26(2):41–45. PMID: 10894554
48. Okazaki M., Shimizu I., Ishikawa M., Fujiwara S., Yamamoto H., Shiraishi T., et al. Gastric mucosal levels of prostaglandins and leukotrienes in patients with gastric ulcer after treatment with rabeprazole in comparison to treatment with ranitidine. J Med Invest. 2007;54(1–2):83–90. DOI: 10.2152/jmi.54.83
49. Ivashkin V.T., Maev I.V., Ivashkin K.V., Korochanskaya N.V., Lopina O.D., Lapina T.L. Trukhmanov A.S., Lapina T.L., et al. The role of protective factors disorders of acid-related diseases pathogenesis. Rus J Gastroenterol Hepatol Coloproctol. 2016;26(3):115–6 (In Russ.).
Review
For citations:
Ivashkin V.T., Maev I.V., Trukhmanov A.S., Sheptulin A.A., Simanenkov V.I., Lapina T.L., Khlynov I.B., Dekhnich N.N., Lopina O.D., Alekseeva O.P., Korochanskaya N.V., Osipenko M.F., Pavlov P.V., Pirogov S.S., Tarasova G.N., Uspenskiy Yu.P., Andreev D.N., Rumyantseva D.E. Deprescribing and Optimal Selection of Proton Pump Inhibitors (Contributions of the 26th United Russian Gastroenterology Week). Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2020;30(6):7-18. (In Russ.) https://doi.org/10.22416/1382-4376-2020-30-6-7-18