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Optimal dose of intravenous pantoprazole in patients with peptic ulcer bleeding requiring endoscopic hemostasis in Korea

Cited 17 time in Web of Science Cited 17 time in Scopus
Authors
Choi, Kee Don; Kim, Nayoung; Jang, In-Jin; Park, Young Soo; Kim, Jung-Ryul; Jung, Hyun Chae; Song, In Sung; Shin, Jai Moo; Cho, Joo Youn
Issue Date
2009-10
Publisher
WILEY-BLACKWELL PUBLISHING, INC
Citation
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY; Vol.24 10; 1617-1624
Keywords
CYP2C19Helicobacter pyloriproton pump inhibitorpeptic ulcer bleedingintravenous infusions
Abstract
Background and Aim: The lowest effective dose of proton pump inhibitors (PPI) for prevention of peptic ulcer rebleeding remains unclear. The objective of the present study was to evaluate whether low-dose PPI has a similar efficacy to high-dose i.v. administration for maintaining intragastric pH above 6. Methods: Sixty-one patients with bleeding ulcers were randomized into one of three groups after endoscopic hemostasis: pantoprazole 80 mg bolus followed by 8 mg/h; 40 mg, 4 mg/h infusion; and bolus injection of 40 mg every 24 h. Intragastric pH values and rebleeding rates were measured. In addition, pharmacokinetic parameters and association with CYP2C19 polymorphisms and H. pylori infection were assessed. Results: Mean percentage of time with intragastric pH > 6, and the proportion of patients with pH > 6 for more than 60% of the time were significantly higher in the 40 mg, 4 mg/h infusion group compared to the 40 mg bolus injection. There was no significant difference between the 80 mg, 8 mg/h and the 40 mg, 4 mg/h groups. In the H. pylori (-) group, only 40% of patients that received continuous infusion reached the target pH > 6 for more than 60% of the time; this was significantly lower than the H. pylori (+) group, 87.5% (P = 0.026). Conclusions: A continuous infusion, regardless of high or low dose, was more effective for acid suppression than a 40 mg bolus PPI injection in Korea. H. pylori infection was an important factor for the maintenance of an intragastric pH > 6.
ISSN
0815-9319
Language
English
URI
http://hdl.handle.net/10371/76436
DOI
https://doi.org/10.1111/j.1440-1746.2009.05939.x
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College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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