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Proton pump inhibitor safety. (GI Disorders).

Patients have used proton pump inhibitors to stop gastric acid production for up to 17 years without increasing their risk of developing gastric carcinoids.

This finding is "reassuring for patients regularly using a proton pump inhibitor to treat gastroesophageal reflux or Barrett's esophagus," Dr. Fathia Gibril said in a poster presentation at the annual Digestive Disease Week.

When omeprazole (Prilosec) came onto the market in the mid-1980s as the first proton pump inhibitor approved for use in the United States, many experts were concerned that long-term, chronic use might raise a patient's risk of gastric carcinoids. This cancer appeared at an accelerated rate in some of the animal models that had been used to test the safety of long, uninterrupted use.

Dr. Gibril and her associates reviewed the experience of 143 patients who have undergone continuous treatment with omeprazole for sporadic Zollinger-Ellison syndrome while they were patients at the National Institutes of Health. The period of treatment for these patients ranged from 1.2 to 17.6 years, and included 8 patients treated for at least 15 years and 54 other patients who were treated for more than 9 years.

The median maintenance dosage that these patients received was 40 mg/day; the range of dosages was from 20 to 200 mg/day About half the patients received their medication as a single daily dose; the other half received it b.i.d.

None of the patients had any clinical, biochemical, or hematologic abnormalities associated with their omeprazole treatment. Two of the 143 patients developed gastric carcinoids during omeprazole treatment, which is consistent with the 1% historic incidence of this disease in patients with sporadic Zollinger-Ellison syndrome, said Dr. Gibril of the digestive diseases branch of the NIH in Bethesda.
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Author:Kubetin, Sally Koch
Publication:OB GYN News
Date:Dec 1, 2001
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