Use Of Esomeprazole Research Articles

Preliminary evaluation of ionized magnesium levels in dogs on long-term esomeprazole administration.

To investigate the level of whole-blood ionized magnesium (iMg) in dogs with long-term use of proton pump inhibitors (PPIs). The study included 10 client-owned dogs with esomeprazole administration over 6 months and 62 healthy dogs to determine de novo reference interval (RI) of iMg. Dogs that received esomeprazole for 6 months or longer were retrospectively reviewed to determine the incidence of hypo- or hypermagnesemia based on the de novo RI. Additionally, the iMg levels from the study group were compared with those of 20 age-, sex-, and body weight-matched controls from the 62 dogs. The median (range) duration of esomeprazole usage was 26 months (6 to 94). The de novo RI for iMg was determined as 0.73 (90% CI, 0.58 to 0.87) to 1.43 mg/dL (90% CI, 1.33 to 1.46). Based on the RI, none of the dogs with long-term esomeprazole developed hypo- or hypermagnesemia. The iMg from the matched control group was 1.17 mg/dL (90% CI, 0.83 to 1.46). The lowest iMg after 6 months of esomeprazole administration (90% CI, 0.96 mg/dL, 0.87 to 1.41) was significantly lower than the control group (P = .031). The iMg measured at the end of long-term esomeprazole treatment was 1.03 mg/dL (90% CI, 0.87 to 1.41) and not significantly different from the control group (P = .179). Ionized hypomagnesemia was not observed after long-term use of esomeprazole in the small number of dogs included in this study. Robust RI needs to be determined in future studies to investigate the incidence of hypomagnesemia in dogs with long-term use of PPIs. Future studies in a larger number of dogs are warranted to confirm the findings from the present study and to determine whether the long-term use of esomeprazole in dogs is at risk of developing ionized hypomagnesemia.

Effect of concomitant use of esomeprazole on levodopa pharmacokinetics and clinical symptoms in patients with Parkinson's disease

BackgroundProton pump inhibitors (PPIs), which inhibit gastric acid secretion, are frequently prescribed to patients with Parkinson's disease (PD). Levodopa, the gold-standard treatment for PD, demonstrates enhanced solubility in acidic environments. Although PPIs increase gastric pH and may affect levodopa absorption, the effect of concomitant PPI use on levodopa pharmacokinetics in patients with PD remains unknown. This study aimed to investigate the effect of the concomitant use of esomeprazole, a PPI, on the pharmacokinetics of levodopa and carbidopa and clinical symptoms in patients with PD. MethodsWe prospectively enrolled 40 patients with PD and compared the pharmacokinetics of levodopa and carbidopa and clinical symptoms before and two weeks after the concomitant use of esomeprazole. ResultsThe plasma concentrations of levodopa 30 min after concomitant oral administration of levodopa and esomeprazole were significantly lower (4.92 ± 4.10 μmol/L) than those without concomitant esomeprazole use (6.26 ± 3.75 μmol/L; p = 0.027). The plasma concentrations of carbidopa showed no significant differences with respect to concomitant esomeprazole use. Significant elevation was recorded in all subscores of the Movement Disorder Society-sponsored revision of the Unified Parkinson's disease Rating Scale scores after concomitant use of esomeprazole. No significant differences were observed between Helicobacter pylori-negative and Helicobacter pylori-positive patients. Non-elderly patients (age ≤ 70 years) tended to be more susceptible to the effect of esomeprazole on levodopa pharmacokinetics and clinical symptoms. ConclusionsThe unnecessary use of PPIs should be avoided in patients with PD, especially in non-elderly patients, to improve absorption of levodopa.

Impact of the addition of clinical pharmacy services to the cardiac catheterization laboratory.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Our cardiology pharmacy team recently expanded services to the cardiac catheterization laboratory (CCL) with the addition of a dedicated pharmacist; since that time, numerous process improvement initiatives have been implemented and medication review has been expanded. We conducted a single-center retrospective chart review. The primary outcome was the percentage of patients discharged from the CCL on appropriate guideline-directed medical therapy components after percutaneous coronary intervention (PCI) before and after integration of dedicated pharmacist services in the CCL. Secondary outcomes were assessed for all patients discharged from the CCL after implementation of a pharmacy presence and included the total number of pharmacist interventions at discharge, the number of prescriptions directed to our outpatient pharmacy, the number of medication reconciliations performed, the number of "protect your stent" educational sessions completed, and the number of clinically significant pharmacist interventions to the medication regimens of patients who underwent PCI. After a dedicated pharmacist was integrated to review CCL discharges, significantly more patients were discharged on high-intensity statin therapy (47.9% vs 78.0%; P < 0.0001) and fewer patients were discharged on omeprazole or esomeprazole prescribed concurrently with clopidogrel (18.7% vs 3.9%; P < 0.0001) following PCI. Of the patients who underwent PCI after addition of the pharmacist (n = 259), 23.9% (n = 66) had a clinically significant pharmacist intervention at discharge and 96.5% (n = 250) received protect your stent education. Of all discharges following pharmacist integration (n = 3,501), 13.6% (n = 477) had at least one pharmacist intervention, 771 prescriptions were sent to our outpatient pharmacy, and 66.4% (n = 2,325) of patients had a medication reconciliation completed. Addition of a dedicated pharmacist to the CCL was associated with increased rates of high-intensity statin prescribing and decreased use of esomeprazole and omeprazole with clopidogrel.

Natural language processing assisted detection of inappropriate proton pump inhibitor use in adult hospitalised patients

ObjectivesTo establish a clinical application monitoring system for proton pump inhibitors (PPI-MS) and to enhance the detection and intervention of inappropriate PPI use in adult hospitalised patients.MethodsNatural language processing technology...

Time-to-onset Analysis of Rhabdomyolysis due to Different Proton Pump Inhibitors Using a Pharmacovigilance Database.

Recent research has increasingly demonstrated an association between proton pump inhibitors (PPIs) and serious adverse events. This study aimed to evaluate the association between PPI and rhabdomyolysis (RM), examining its time-to-onset profiles using the Japanese Adverse Drug Event Report (JADER) database. Data spanning from April 2004 to March 2022 were used. The association between PPIs and RM was evaluated using the reporting odds ratio (ROR), adjusted for sex and age. Subsequent analyses were conducted after excluding cases involving concomitant use of statins or fibrates. Furthermore, the onset time of RM and Weibull distribution parameters were calculated to evaluate the expression profile of RM, and the outcomes were examined. RM was associated with the use of esomeprazole, omeprazole, and rabeprazole, even in the absence of concomitant statin or fibrate use. The median time to RM onset varied among PPIs, ranging from 6.5 to 127 d. The Weibull distribution parameters indicated that the hazard types of nearly all orally administered PPIs were classified as early failure or close to random failure. Regarding outcomes, cases of death were reported for all PPIs except vonoprazan. The findings suggest the need for vigilant monitoring of RM during PPI administration, particularly in the early stages, considering the varying onset times.

The pharmacokinetics and pharmacodynamics of esomeprazole in sheep after intravenous dosing.

Abomasal (gastric) ulceration is a morbidity in sheep, and currently, there is a paucity of pharmacokinetic and pharmacodynamic data for gastroprotectant drugs reported for this species. The proton pump inhibitor esomeprazole has been used in small animal and human patients for gastroprotection via increasing the gastric pH. The objective of this study was to report the pharmacokinetic parameters and pharmacodynamic effect of esomeprazole in sheep after single intravenous dosing. Four healthy adult Southdown cross ewes had blood collected over a 24 h time period after single intravenous dosing of esomeprazole at 1.0 mg/kg. Abomasal fluid was sampled over 24 h before and after esomeprazole administration. Plasma samples were analyzed for concentrations of esomeprazole and the esomeprazole metabolite, esomeprazole sulfone by high performance liquid chromatography. Pharmacokinetic and pharmacodynamic data were evaluated with specialized software. Esomeprazole was rapidly eliminated after IV administration. Elimination half-life, area under the curve, initial concentration (C0), and clearance were 0.2 h, 1,197 h*ng/mL, 4,321 ng/mL, and 0.83 mL/h/kg, respectively. For the sulfone metabolite elimination half-life, area under the curve and maximum concentration were 0.16 h, 22.5 h*ng/mL, and 65.0 ng/mL, respectively. Abomasal pH was significantly elevated from 1 to 6 h after administration and remained above 4.0 for at least 8 h after administration. No adverse effects were noted in these sheep. Esomeprazole was rapidly eliminated in sheep, similar to goats. Abomasal pH was increased, but future studies will be necessary to develop a clinical management approach to the use of esomeprazole in sheep.

Proton pompa inhibitörü esomeprazolün uzun süre kullanımına bağlı gelişen reversibl azospermi: Bir olgu sunumu

OBJECTIVES: The long-term use of esomeprazole, a commonly prescribed proton pump inhibitor, has been associated with a decrease in sperm count and motility, as well as infertility in recent studies. We aimed to present the case of reversible azoospermia developed due to the use of esomeprazole in this study. CASE REPORT: In our study, we examined a 25-year-old unmarried male patient with a desire for children who had been using esomeprazole (40 mg/day) for approximately two years due to gastroesophageal reflux disease. The patient presented to our clinic intermittently with a dull scrotal pain, which was present in both testicles and resolved spontaneously after a short period. The physical examination of the patient revealed no pathological findings, and the testicular volumes and serum hormone parameters were within the normal reference values. The result of scrotal color doppler ultrasound performed on the patient in an external center was reported as scrotal color doppler ultrasound examination within normal limits. Upon the initial presentation of the patient, the semen analysis reported azoospermic pellet positivity. Subsequently, a repeat semen analysis was requested from the patient at a 4-week interval, and the result was once again reported as azoospermic pellet positive. As a result, we discontinued the use of esomeprazole for the patient, and during the first and fourth-month follow-ups, there was a gradual improvement in sperm parameters. The semen analysis parameters evaluated in the fourth month were observed within the normal reference values. CONCLUSIONS: We aimed to emphasize the necessity of considering the use of esomeprazole, which is frequently preferred for gastrointestinal system disorders in our country, as a potential etiology of azoospermia, in a young patient who had been using it for a long time and experienced improvement after discontinuation of the medication. Keywords: azoospermia, esomeprazole, infertility

EVALUATION OF ANTIULCEROGENIC EFFECT OF CRYOCONSERVATED PLACENTA EXTRACT ON THE MODEL OF ETHANOL-PREDISONOLIC LESIONS OF THE GASTRIC MUCOSA

Relevance. Gastric and duodenal ulcers occur in 6-10% of the adult population, and mortality from peptic ulcers ranges from 5 to 15%. Conservative treatment of this disease almost always involves the use of antisecretory and antibacterial drugs. Existing treatment regimens for peptic ulcer disease, focused on key pathogenetic mechanisms, do not take into account the individual adaptive and trophological characteristics of patients. As a potential antiulcer agent, our attention was drawn to the cryopreserved placenta extract ("Cryocell-cryoextract placenta"). It eliminates the ulcerogenic effect of anti-inflammatory drugs of non-steroidal nature, without affecting their therapeutic efficacy.&#x0D; Objective: to characterize the anti-ulcerogenic effect of therapeutic and prophylactic use of cryopreserved placenta extract in the model of alcohol-prednisolone gastric lesions in rats.&#x0D; Methods. The study was performed on 28 male rats weighing 200-220 g. they were randomized into four groups: I (n = 7) – intact rats, II (n = 7) – control – rats with model pathology (alcohol-prednisolone gastric lesion) without treatment, III (n = 7) – rats with alcohol-prednisolone gastric lesions, which were injected with cryoextract placenta (0.16 ml / kg body weight, intramuscularly), IV (n = 7) – rats with alcohol-prednisolone gastric lesions, which were administered the reference drug esomeprazole, proton pump inhibitor (50 mg / kg , intragastric). Gastric lesions in rats were simulated by intragastric single administration of prednisolone (20 mg/kg) dissolved in 80.0% ethanol (0.6 ml/100 g body weight). Cryoextracts of the placenta were administered intravenously in a prophylactic mode – 1 time per day for 4 days before and 1 time 60 minutes after the introduction of ethanol-prednisolone mixture. In 24 h. after administration of the mixture, rats were removed from the experiment and the size of the stomach (bloating) and the presence of adhesions with adjacent organs were evaluated macroscopically by the following criteria: erosions and hemographies, hyperemia, edema and mucosal fold disorders. For each group, the percentage of experimental animals was calculated according to these characteristics and the average value of their severity. The values ​​of the ulcer index were calculated for each group.&#x0D; Results. The study showed that the introduction of placental cryoexact as well as the reference drug esomeprazole led to a statistically significant (p&lt;0.05) reduction of three times the prevalence of gastric ulcers in rats after administration of alcohol-prednisolone mixture. The use of placental cryoextract in the treatment-and-prophylactic regimen led to a statistically significant (p&lt;0.05) decrease in the value of the ulcer index in 13 times relative to the control rats, and the average score of macroscopic assessment of gastric mucosa was 3.5 times lower and was 1.1±0.24 and 3.9±0.26, respectively. In animals treated with esomeprazole 2 times more moderate (2 [0.5; 3] points) hyperemia of the central nervous system (57.1% and 28.6%, respectively) and several times more moderate (2 [0; 2]). points) edema of the secondary school. In addition, edema of the central nervous system in rats administered esomeprazole led to a clear (3 [2; 3] points) violation of the folding of the central nervous system in 71.4% of rats. In contrast to the use of esomeprazole, placental cryoextract more significantly leveled the hyperemia induced by the introduction of alcohol-prednisolone mixture and edema of the gastric mucosa, which were observed in only 28.6% and 14.3% of rats, respectively.&#x0D; Conclusions. Therapeutic and prophylactic use of placental cryoextract was accompanied by statistically significant (p &lt;0.05) comparable to esomeprazole antiulcer efficacy in the model of ethanol-prednisolone gastric lesion and amounted to 92.3%.

Role of proton pump inhibitor in healing after choanal atresia repair: a randomized control trial

BackgroundChoanal atresia (CA), defined as the anatomical closure of the choanae in the nasal cavity, is relatively uncommon disease entity with an estimated incidence of 1:5000–7000 births. Post-operative restenosis remains a common complication of the endoscopic CA repair. Risk factors for restenosis include nasopharyngeal reflux and gastroesophageal reflux.ResultsForty patients who underwent choanal atresia repair were divided randomly into 2 groups. Group A patients received postoperative PPI medication compared to group B patients who acted as control who underwent the same operation without receiving postoperative proton pump inhibitor medication.Only 2 patients (10%) in group A experienced restenosis compared to 8 patients (40%) in the control group B.ConclusionThe use of esomeprazole which is a proton pump inhibitor acting as an antireflux should be considered, in postoperative treatment, to decrease the rate of choanal restenosis by preventing inflammation on choanal mucosa which can enhance good healing mechanism.

Interaction of esomeprazole with insulin detemir and human albumin: A potential cause of hypoglycemia

Insulin detemir (IDt) is long-acting insulin whose protraction mechanism is based on a covalently attached fatty acid to an insulin molecule. Utilizing the high affinity of fatty acids towards human serum albumin (HA), the modified detemir molecule binds with good affinity to HA, which functions as a reservoir that leads to a slow and prolonged release of insulin. However, questions were raised over potential interactions between other drugs and IDt through competitive binding on the binding site(s) of HA. In a previous study, concomitant use of esomeprazole (Esom) and erythromycin resulted in severe hypoglycemia, and thus: the drugs including Esom were suggested as enhancers of IDt action through displacing it from its binding site on HA. To further study this possibility, studies utilizing different techniques including, semipermeable membrane dialysis, capillary electrophoresis, UV,NMR spectroscopy, and molecular docking were carried out. Results from various techniques supported the simultaneous binding of Esom along with IDt to HA (i.e., binding in two different sites without signs of competition between the two). Moreover, capillary electrophoresis suggested an increase in the binding affinity of Esom to HA in the presence of IDt (1.9 × 103 Vs 2.7 × 104M−1). Perhaps most interesting was the observation that Esom could bind directly to IDt which was evidenced by all the employed techniques. Direct binding of Esom to IDt, might explain the enhancement in insulin action associated with the concomitant use of Esom. Therefore, Esom might represent a leading insulin-sensitizing compound that might lead to more effective insulin enhancing and less unwanted effects.

Gastrointestinal disorders in patients with COVID-19: diagnoses and treatment during the pandemic

Background. The pandemic caused by the coronavirus disease 2019 (COVID-19) is a topic that is currently in the spotlight of the world community. The use of non-steroidal anti-inflammatory drugs (NSAIDs) in combination with new oral anticoagulants (dabigatran, rivaroxaban, apixaban, etc.) and acetylsalicylic acid by the significant number of patients during the pandemic, caused by COVID-19, raises the question about the safety of the influence of each drug on the occurrence of gastrointestinal complications. The development of algorithms to prevent damage to the gastrointestinal mucosa on the background of these drugs is becoming a priority. The purpose was to examine the presence of gastrointestinal disorders using the Gastrointestinal Symptom Rating Scale (GSRS) in convalescents after COVID-19 and to evaluate the effectiveness of esomeprazole for correction of these disorders. Materials and methods. We surveyed 92 (48 men and 44 women) convalescents after COVID-19. The mean age of individuals was (49.2±2.0) years. To conduct a survey of patients who had COVID-19, we developed a questionnaire which included patient’s passport data, age, gender. In addition, patients reported how COVID-19 was diagnosed, what drugs they were taking during treatment, and whether they needed oxygen therapy. Subsequently, convalescents after COVID-19 answered questions from the GSRS. Information was collected and the questionnaire was completed by telephone survey. Depending on the data of GSRS, esomeprazole (Ezonexa) was prescribed to patients at a dose of 20 mg 1 time per day, 30 minutes before meals, for 30 days. During the follow-up survey on day 30 of esomeprazole intake, patients re-answered the GSRS questions. Results. Thirty days after starting esomeprazole intake at a dose of 20 mg 1 time per day, 92 convalescents after COVID-19 showed a significant reduction (p&lt;0.001) in the manifestations of reflux, abdominal pain and dyspeptic syndromes compared to the results before treatment ((2.3±0.1), (4.3±0.2), (5.7±0.3) versus (4.3±0.3), (9.3±0.4), (8.6±0.6), respectively). Esomeprazole was equally effective (p&gt;0.05) in influencing the severity of reflux, abdominal pain, dyspeptic, diarrheal and constipation syndromes in both men and women: (2.3±0.1), (4.3±0.2), (5.7±0.3), (3.9±0.3), (3.0±0.1) versus (2.4±0.1), (4.2±0.2), (6.0±0.4), (4.0±0.4), (3.1±0.1), respectively. Esomeprazole was also equally effective (p&gt;0.05) in the impact on the severity of reflux, abdominal pain, dyspeptic, diarrheal and constipation syndromes among patients receiving acetylsalicylic acid and those treated with rivaroxaban: (2.5±0.2), (4.2±0.2), (5.6±0.2), (3.9±0.4), (3.1±0.1) versus (2.2±0.1), (4.4±0.3), (6.4±0.6), (4.2±0.4), (3.0±0.1), respectively. Esomeprazole at a dose of 20 mg 1 time per day was equally effective (p&gt;0.05) in relation to the dynamics of the severity of syndromes in patients receiving paracetamol and one NSAID and in those receiving paracetamol and 2 NSAIDs. In particular, in people receiving paracetamol and one NSAID, on the background of esomeprazole administration, the severity of reflux, abdominal pain, dyspeptic, diarrheal and constipation syndromes were (2.4±0.1), (4.3±0.2), (5.8±0.3), (4.1±0.3), (3.1±0.1) and in patients taking paracetamol and 2 NSAIDs— (2.1±0.2), (4.5±0.4), (6.7±0.7), (4.4±0.7), (3.0±0.1), respectively. Conclusions. Esomeprazole (Ezonexa) effectively reduces (p&lt;0.001) the severity of reflux, abdominal pain and dyspeptic syndromes in convalescents after COVID-19. The use of Esomeprazole (Ezonexa) demonstrates the same efficacy (p&gt;0.05) in men and women when receiving both ASA and rivaroxaban and during the treatment with both paracetamol and one NSAID and paracetamol and 2 NSAIDs.

Esomeprazole in the treatment of equine glandular gastric disease

Background:Equine glandular gastric disease is a highly prevalent disease, for which there is no universally effective treatment. Given the widespread use of esomeprazole in the treatment of peptic ulcer disease in humans, its use in horses warrants further investigation.Objective:To assess rates of healing of equine glandular gastric disease using oral esomeprazole.Study design:Retrospective case series.Methods:Medical records and gastroscopy images of horses diagnosed with equine glandular gastric disease and treated with esomeprazole by Avon Ridge Equine Veterinary Services were reviewed.Results:Out of four horses treated with esomeprazole for 28 days, 75% (three) healed and 25% (one) did not improve. Out of three horses treated with esomeprazole for 14 days, 67% (two) healed and 33% (one) did not improve.Main limitations:The study was limited by its retrospective nature and small sample size.Conclusions:Esomeprazole may be a valid first-line treatment option for equine glandular gastric disease. Larger and more robust studies of esomeprazole are warranted.

Effect of esomeprazole on lipid profile in patients with peptic ulcer

Esomeprazole; a newly introduced PPI has been widely prescribed by healthcare providers due to its improved pharmacokinetic profile. Most users could have other diseases and the PPIs are indicated as acid-suppressor to minimize gastric side effects of polypharmacy. A high percentage of users could suffer from cardiovascular diseases and lipid dysmetabolism. Hence, this study was designed to determine the impact of long-term use of esomeprazole on lipid profile in a normal subject other than having peptic ulcer for which esomeprazole has been indicated. Results confirmed that esomeprazole reduced triglyceride and HDL levels and elevated total cholesterol level and correspondingly LDL level was elevated, however, no effect was noticed with VLDL. To sum up, esomeprazole impaired lipid metabolism in apparently normal healthy individuals apart from having peptic ulcer for which the esomeprazole was indicated, this finding rise a caution during prescribing esomeprazole for the patient with multiple diseases and polypharmacy including cardiovascular ailments.

PGI30 Assessment of Prescription Use and Patterns of Drug Related Problems in Patients with Peptic Ulcer Disease in Southern India.

The aim of the study is to assess the usage of drugs in the management of peptic ulcer and to identify the association of drug-related problems(DRPs). A prospective observational study was conducted over a period of nine months in the department of gastroenterology among both in-patients and out-patients. Patients diagnosed endoscopically with Peptic Ulcer Disease (PUD) were enrolled in the study after obtaining inform consent form. Descriptive statistics were applied to this study. A total of 180 patients were included in the study with 108 (60%) out-patients and 72 (40%) in-patients. Clarithromycin based triple therapy [n= 104 (57.77%)] with Esomeprazole based Helicobacter Pylori (HP) kit [n=90 (86.53%)], Pantoprazole based HP kit [n=14 (13.46%)] were started as fixed drug–dose combination therapy and monotherapy in 45% of the patients. The average maintenance treatment with proton pump inhibitors lasted for 42.12 ± 5.94 days. In-patients with complicated Peptic Ulcer Disease were administered with proton pump inhibitor (PPIs) 80mg bolus followed by PPI infusion 8mg/hr. for a period of 19.5±6.69 hours. A total of 138 (76.66%) participants encountered at least one drug-drug interactions(DDIs) and drug interactions accounted for 71.64% of overall drug related problems. Among 235 DDI’s, minor interactions were 149 (63.40%), the interactions to be monitor closely were 74 (31.49%) and serious interactions were 12 (5.10%). Overall, 10 (3.08%) experienced adverse drug reaction (ADR) as a DRP. Among 108 (60%) ambulatory patients, 10 (9.25%) experienced ADR. The H-pylori kit is popular clarithromycin-based therapy used in H-pylori eradication. Proton pump inhibitor was the most common therapy used in combination or alone, and use of esomeprazole was safe and compliant with the American College of Gastroenterology guidelines. In-patients the prophylactic use of antibiotics was seen due to complicated ulcers. DRPs encountered was DDIs followed by sub-therapeutic dose and failure to receive maintainance dose of PPI.

The effect of esomeprazole vs famotidine on aspirin/clopidogrel dual therapy after percutaneous coronary intervention.

Regarding drug interactions between proton pump inhibitors (PPIs) and dual antiplatelet therapy (DAPT), controversies have arisen over the possibility that PPIs may interfere with the antiplatelet effect of DAPT. However, whether this interaction is drug-specific or a class effect needs to be determined. It is not clear whether famotidine, an H2-receptor antagonist (H2RA), interacts with DAPT. The aim of this study was to assess the impact of esomeprazole and famotidine on the efficacy of DAPT. The study involved 160 patients undergoing elective percutaneous coronary interventions and treated with DAPT and concomitant use of esomeprazole (40 mg/d) or famotidine (40 mg/d). Platelet reactivity was measured with adenosine diphosphate (ADP)-induced light transmittance aggregometry (LTA) and vasodilator-stimulated phosphoprotein phosphorylation-platelet reactivity index (VASP-PRI) at baseline, 14 and 30 days after applying randomized acid-suppressing agents. No significance differences were observed in treatment-by-period interactions with LTA values (p = 0.298) and VASP-PRI values (p = 0.867), which suggested no carryover effect in either regimen over the 30-day treatment period. Intergroup comparisons were done between the 2 groups at 3 times, and similar findings were observed at each time (all p > 0.05). As for intragroup measurements among the separate times, significantly lower LTA and VASP-PRI values existed on day 14 for both agents (both p < 0.05). The antiplatelet effect of DAPT was not affected by concomitant use of esomeprazole or famotidine. These 2 agents were much less likely than CYP2C19 polymorphisms to influence aspirin/clopidogrel therapy, supporting the assertion that the pharmacodynamic interaction between aspirin/clopidogrel and acid-suppressing agents is a drug-specific rather than a class effect.

EVALUATION OF PSORIASIS TREATMENT WITH ESOMEPRAZOLE - A PILOT STUDY.

Psoriasis is an inflammatory skin disease that affects 1%-3% of Caucasian populations and may be persistent, disfiguring and stigmatising. Proton pump inhibitors (PPI) are potent blockers of gastric acid secretion. They are widely regarded as the agents of choice for the treatment of acid-peptic disorders. In addition to anti-secretory effects PPI have been found to have anti-oxidant properties and direct effects on neutrophils, monocytes, endothelial, and epithelial cells that might prevent inflammation. This study evaluated the treatment of psoriasis with esomeprazole. Ten patients were selected and psoriasis was evaluated according to Psoriasis Area and Severity Index (PASI). Exclusion criteria included concomitant use of any treatment for Psoriasis, organic diseases, use of other PPI than esomeprazole. Patients were medicated with esomeprazole 40 mg B.I.D. for 90 days. At the 90th day the patients were evaluated according PASI score. Statistically significant results were seen when compared PASI before and at 90th day of treatment (P=0.0002). The use of esomeprazole for psoriasis resulted in excellent clinical results with a significant reduction of PASI score.

Monitoring the growing use of esomeprazole

Like all proton‐pump inhibitors (PPIs), esomeprazole has a generally good safety record. However, there is no true lowpotency formulation of esomeprazole available and therefore the growing use of this drug may increase the risk of dosedependent PPI adverse effects, argues Angus Thompson.

Helicobacter pylori infection and acid-related diseases against the background of metabolic-associated conditions: mechanisms of development and management

The author presents data on the role of H. pylori infection in the initiation and progression of the changes in metabolic status of patients with type 2 diabetes mellitus (DM-2), insulin resistance, obesity, cardiovascular diseases. Evidence has been obtained indicating the contribution of H. pylori infection to an increase in the incidence of myocardial infarction and stroke in patients with DM-2. The duration of the use of proton pump inhibitors in the context of the H. pylori presence in metabolic-associated states, as well as their effects on the microbiota of the esophagus and stomach, has been substantiated. Decisions on the PPI therapy duration, not only at acid-dependent diseases, but also during eradication therapy, should be based on the available clinical recommendations and protocols for the treatment of these diseases, with account of patient’s age, individual characteristics, concomitant diseases, the dynamics of the disease course and the presence of complications. The use of PPI results in the changes in the stomach microbiota composition, in the pH increase up to 4.0 and higher, thus promoting the rapid multiplication of Lactobacillus spp. and Streptococcus spp. as well as other anaerobes. However, these investigations’ results of the usefulness or harm of such changes are contradictory and require further research. The expediency of the use of esomeprazole (Ezonexa) in these patients in view of the features of pharmacokinetics, pharmacodynamics, as well as clinical efficacy and safety has been substantiated. The peculiarity of esomeprazole metabolism is its stereoselectivity phenomenon, which provides better control of secretion, as well as a longer-lasting esomeprazole effects in patients who rapidly metabolized PPIs. To improve the results of treatment of patients with metabolic-associated conditions, the administration of Laktiale probiotic is justified.

ESTIMATION OF CLINICAL AND PHARMACOECONOMIC EFFICIENCY OF PROTON PUMP INHIBITORS DURING GASTROESOPHAGEAL REFLUX DISEASE (GERD) TREATMENT

Aim. The study was conducted to estimate the clinical and pharmacoeconomic efficiency of proton pump inhibitors (PPIs) omeprazole and esomeprazole when GERD patients undergo a course of medical treatment.Materials and methods. 25 GERD patients with a history of the disease for more than 5 years were under observation in Krasnodar regional clinical hospital № 2 from 2017 till 2018. All the patients have been thoroughly examined. Conservative therapy included the «gold standard» of proton pump inhibitors. Evaluation of the efficiency included the number of disease relapses in the period of dynamic observation and the calculation of the cost-effectiveness ratio.Results. When patients were taking esomeprazole, the relapses of the GERD disease were rare. The cost-effectiveness ratio was lower.Conclusion. The use of esomeprazole during the treatment of GERD patients has lower economic expenditures. The relapses of the disease are also less frequent.

Assessment of the risk of acute kidney injury associated with the use of pantoprazole and esomeprazole

Many recent observational studies suggest that there is an association between the use of proton pump inhibitors (PPIs) and kidney disease, but no studies comparing the relative risk between PPIs have been conducted. Hence, we designed a study to evaluate the risk of acute kidney injury (AKI) associated with the use of pantoprazole and esomeprazole. This cross-sectional pilot study included 52 pantoprazole users, 51 esomeprazole users and 50 non-PPI users. Biochemical parameters, such as urea, creatinine, sodium, potassium, chloride, bicarbonate, calcium, magnesium, phosphorus, and urine neutrophil gelatinase-associated lipocalin (NGAL) levels were determined to estimate the risk of AKI. Relative to non-exposure to PPIs, the use of pantoprazole increased the risk of AKI, as did the use of esomeprazole. Serum magnesium values were inversely correlated with the NGAL levels in the pantoprazole and esomeprazole group, but not in the non-exposed group. Our study reveals that the use of pantoprazole and esomeprazole are both associated with an increased risk of AKI.