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Clinical Efficacy of Esomeprazole in the Prevention and Healing of Gastrointestinal Toxicity Associated with NSAIDs in Elderly Patients

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Abstract

NSAIDs are widely prescribed for the treatment of pain, inflammation and rheumatic disorders, but their use is associated with adverse gastrointestinal effects, ranging from dyspeptic symptoms and peptic ulcers to more serious complications. Elderly patients are at high risk of experiencing NSAID-induced gastrointestinal tract injury and should be considered candidates for prophylactic pharmacological therapy. In studies conducted in adult patients, proton pump inhibitors (PPIs) such as esomeprazole have been shown to prevent or reduce NSAID-induced gastrointestinal injury. The beneficial effects of esomeprazole can be ascribed largely to its ability to maintain sustained inhibition of gastric acid secretion, although there is evidence to suggest that pharmacodynamic properties unrelated to acid inhibition may also contribute to the gastroprotective effects of this agent. Although there are limited data on the use of esomeprazole specifically in elderly patient populations, studies of patients at high risk of NSAID-induced gastrointestinal toxicity because of advanced age indicate that this PPI is both effective and well tolerated when administered in conjunction with NSAIDs. Thus, esomeprazole can be regarded as a useful option for prophylactic therapy in elderly patients receiving long-term NSAID therapy.

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References

  1. Dubois RW, Melmed GY, Henning JM, et al. Guidelines for the appropriate use of non-steroidal anti-inflammatory drugs, cyclo-oxygenase-2-specific inhibitors and proton pump inhibitors in patients requiring chronic anti-inflammatory therapy. Aliment Pharmacol Ther 2004; 19(2): 197–208

    Article  PubMed  CAS  Google Scholar 

  2. Kaufman DW, Kelly JP, Rosenberg L, et al. Recent patterns of medication use in the ambulatory adult population of the United States: the Slone survey. JAMA 2002; 287(3): 337–44

    Article  PubMed  Google Scholar 

  3. Wolfe MM, Lichtenstein DR, Singh G. Gastrointestinal toxicity of nonsteroidal antiinflammatory drugs. N Engl J Med 1999; 340(24): 1888–99

    Article  PubMed  CAS  Google Scholar 

  4. Laine L, Bombardier C, Hawkey CJ, et al. Stratifying the risk of NSAID-related upper gastrointestinal clinical events: results of a double-blind outcomes study in patients with rheumatoid arthritis. Gastroenterology 2002; 123(4): 1006–12

    Article  PubMed  CAS  Google Scholar 

  5. Lanas A, Ferrandez A. Inappropriate prevention of NSAID-induced gastrointestinal events among long-term users in the elderly. Drugs Aging 2007; 24(2): 121–31

    Article  PubMed  CAS  Google Scholar 

  6. Singh G, Triadafilopoulos G. Appropriate choice of proton pump inhibitor therapy in the prevention and management of NSAID-related gastrointestinal damage. Int J Clin Pract 2005; 59(10): 1210–7

    Article  PubMed  CAS  Google Scholar 

  7. Laporte JR, Ibanez L, Vidal X, et al. Upper gastrointestinal bleeding associated with the use of NSAIDs: newer versus older agents. Drug Saf 2004; 27(6): 411–20

    Article  PubMed  CAS  Google Scholar 

  8. Stillman MJ, Stillman MT. Choosing non-selective NSAIDs and selective COX-2 inhibitors in the elderly: a clinical use pathway. Geriatrics 2007; 62(2): 26–34

    PubMed  Google Scholar 

  9. Hawkey CJ, Langman MJ. Non-steroidal anti-inflammatory drugs: overall risks and management: complementary roles for COX-2 inhibitors and proton pump inhibitors. Gut 2003; 52(4): 600–8

    Article  PubMed  CAS  Google Scholar 

  10. Solomon DH, Schneeweiss S, Glynn RJ, et al. Relationship between selective cyclooxygenase-2 inhibitors and acute myocardial infarction in older adults. Circulation 2004; 109(17): 2068–73

    Article  PubMed  CAS  Google Scholar 

  11. Sun SX, Lee KY, Bertram CT, et al. Withdrawal of COX-2 selective inhibitors rofecoxib and valdecoxib: impact on NSAID and gastroprotective drug prescribing utilization. Curr Med Res Opin 2007; 23(8): 1859–66

    Article  PubMed  CAS  Google Scholar 

  12. Laine L. Proton pump inhibitor co-therapy with nonsteroidal anti-inflammatory drugs: nice or necessary? Rev Gastroenterol Disord 2004; 4Suppl. 4: S33–41

    PubMed  Google Scholar 

  13. Singh G, Rosen Ramey D. NSAID induced gastrointestinal complications: the ARAMIS perspective, 1997 [Arthritis, Rheumatism, and Aging Medical Information System]. J Rheumatol 1998; 51 Suppl.: 8–16

    CAS  Google Scholar 

  14. Hawkey C, Talley NJ, Yeomans ND, et al. Improvements with esomeprazole in patients with upper gastrointestinal symptoms taking non-steroidal antiinflammatory drugs, including selective COX-2 inhibitors. Am J Gastroenterol 2005; 100(5): 1028–36

    Article  PubMed  CAS  Google Scholar 

  15. Nielsen OH, Ainsworth M, Csillag C, et al. Systematic review: coxibs, non-steroidal anti-inflammatory drugs or no cyclooxygenase inhibitors in gastroenterological high-risk patients?. Aliment Pharmacol Ther 2006; 23(1): 27–33

    Article  PubMed  CAS  Google Scholar 

  16. Naesdal J, Brown K. NSAID-associated adverse effects and acid control aids to prevent them: a review of current treatment options. Drug Saf 2006; 29(2): 119–32

    Article  PubMed  CAS  Google Scholar 

  17. Braunwald E, Antman EM, Beasley JW, et al. ACC/AHA guideline update for the management of patients with unstable angina and non-ST-segment elevation myocardial infarction, 2002 [summary article]: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients With Unstable Angina). Circulation 2002; 106(14): 1893–900

    Article  PubMed  Google Scholar 

  18. Blandizzi C, Fornai M, Colucci R, et al. Lansoprazole prevents experimental gastric injury induced by non-steroidal anti-inflammatory drugs through a reduction of mucosal oxidative damage. World J Gastroenterol 2005; 11(26): 4052–60

    PubMed  CAS  Google Scholar 

  19. Suzuki H, Hibi T. Novel effects other than antisecretory action and off-label use of proton pump inhibitors. Expert Opin Pharmacother 2005; 6(1): 59–67

    Article  PubMed  CAS  Google Scholar 

  20. Johnson DA. Review of esomeprazole in the treatment of acid disorders. Expert Opin Pharmacother 2003; 4(2): 253–64

    Article  PubMed  CAS  Google Scholar 

  21. Scott LJ, Dunn CJ, Mallarkey G, et al. Esomeprazole: a review of its use in the management of acid-related disorders. Drugs 2002; 62(10): 1503–38

    Article  PubMed  CAS  Google Scholar 

  22. Chong E, Ensom MH. Pharmacogenetics of the proton pump inhibitors: a systematic review. Pharmacotherapy 2003; 23(4): 460–71

    Article  PubMed  CAS  Google Scholar 

  23. Tonini M, Vigneri S, Savarino V, et al. Clinical pharmacology and safety profile of esomeprazole, the first enantiomerically pure proton pump inhibitor. Dig Liver Dis 2001; 33(7): 600–6

    Article  PubMed  CAS  Google Scholar 

  24. Thiefin G, Beaugerie L. Toxic effects of nonsteroidal antiinflammatory drugs on the small bowel, colon, and rectum. Joint Bone Spine 2005; 72(4): 286–94

    Article  PubMed  Google Scholar 

  25. Wallace JL, McKnight W, Reuter BK, et al. NSAID-induced gastric damage in rats: requirement for inhibition of both cyclooxygenase 1 and 2. Gastroenterology 2000; 119(3): 706–14

    Article  PubMed  CAS  Google Scholar 

  26. Wallace JL. Pathogenesis of NSAID-induced gastroduodenal mucosal injury. Best Pract Res Clin Gastroenterol 2001; 15(5): 691–703

    Article  PubMed  CAS  Google Scholar 

  27. Rodriguez-Tellez M, Arguelles F, Herrerias Jr JM, et al. Antiinflammatory agents less dangerous for gastrointestinal tract. Curr Pharm Des 2001; 7(10): 951–76

    Article  PubMed  CAS  Google Scholar 

  28. Whittle BJ. Gastrointestinal effects of nonsteroidal anti-inflammatory drugs. Fundam Clin Pharmacol 2003; 17(3): 301–13

    Article  PubMed  CAS  Google Scholar 

  29. Jimenez MD, Martin MJ, Alarcon de la Lastra C, et al. Role of L-arginine in ibuprofen-induced oxidative stress and neutrophil infiltration in gastric mucosa. Free Radic Res 2004; 38(9): 903–11

    Article  PubMed  CAS  Google Scholar 

  30. Pai R, Szabo IL, Giap AQ, et al. Nonsteroidal anti-inflammatory drugs inhibit re-epithelialization of wounded gastric monolayers by interfering with actin, Src, FAK, and tensin signaling. Life Sci 2001; 69(25–26): 3055–71

    Article  PubMed  CAS  Google Scholar 

  31. Okabe S, Amagase K. An overview of acetic acid ulcer models: the history and state of the art of peptic ulcer research. Biol Pharm Bull 2005; 28(8): 1321–41

    Article  PubMed  CAS  Google Scholar 

  32. Tarnawski AS. Cellular and molecular mechanisms of gastrointestinal ulcer healing. Dig Dis Sci 2005; 50Suppl. 1: S24–33

    Article  PubMed  CAS  Google Scholar 

  33. Mizuno H, Sakamoto C, Matsuda K, et al. Induction of cyclooxygenase 2 in gastric mucosal lesions and its inhibition by the specific antagonist delays healing in mice. Gastroenterology 1997; 112(2): 387–97

    Article  PubMed  CAS  Google Scholar 

  34. Ma L, del Soldato P, Wallace JL. Divergent effects of new cyclooxygenase inhibitors on gastric ulcer healing: shifting the angiogenic balance. Proc Natl Acad Sci U S A 2002; 99(20): 13243–7

    Article  PubMed  CAS  Google Scholar 

  35. Sanchez-Fidalgo S, Martin-Lacave I, Illanes M, et al. Angiogenesis, cell proliferation and apoptosis in gastric ulcer healing: effect of a selective cox-2 inhibitor. Eur J Pharmacol 2004; 505(1–3): 187–94

    Article  PubMed  CAS  Google Scholar 

  36. Chan FK, Sung JJ. Role of acid suppressants in prophylaxis of NSAID damage. Best Pract Res Clin Gastroenterol 2001; 15(3): 433–45

    Article  PubMed  CAS  Google Scholar 

  37. Elliott SL, Ferris RJ, Giraud AS, et al. Indomethacin damage to rat gastric mucosa is markedly dependent on luminal pH. Clin Exp Pharmacol Physiol 1996; 23(5): 432–4

    Article  PubMed  CAS  Google Scholar 

  38. Green Jr FW, Kaplan MM, Curtis LE, et al. Effect of acid and pepsin on blood coagulation and platelet aggregation: a possible contributor to prolonged gastroduodenal mucosal hemorrhage. Gastroenterology 1978; 74(1): 38–43

    PubMed  CAS  Google Scholar 

  39. Levine RA, Schwartzel EH. Effect of indomethacin on basal and histamine stimulated human gastric acid secretion. Gut 1984; 25(7): 718–22

    Article  PubMed  CAS  Google Scholar 

  40. Rodriguez-Stanley S, Redinger N, Miner PB. Effect of naproxen on gastric acid secretion and gastric pH. Aliment Pharmacol Ther 2006; 23: 1719–24

    Article  PubMed  CAS  Google Scholar 

  41. Thjodliefsson B. Treatment of acid-related diseases in the elderly with emphasis on the use of proton pump inhibitors. Drug Aging 2002; 19(12): 911–27

    Article  Google Scholar 

  42. Bazzoli F, Palli D, Zagari RM. The Loiano-Monghidoro population-based study of Helicobacter pylori infection: prevalence by [13]C-urea breath test and associated test. Aliment Pharmacol Ther 2001; 15: 1001–7

    Article  PubMed  CAS  Google Scholar 

  43. Haruma K, Mihara M, Okamoto E, et al. Eradication of Helicobacter pylori increases gastric acidity in patients with atrophic gastritis of the corpus: evaluation of 24-h pH monitoring. Aliment Pharmacol Ther 1999; 13: 155–62

    Article  PubMed  CAS  Google Scholar 

  44. Labenz J, Tillenburg B, Peltz U, et al. Efficacy of omeprazole one year after cure of Helicobacter pylori infection in duodenal ulcer patients. Am J Gastroenterol 1997; 92: 576–81

    PubMed  CAS  Google Scholar 

  45. Chan FK. Management of high-risk patients on non-steroidal anti-inflammatory drugs or aspirin. Drugs 2006; 66Suppl. 1: 23–8

    PubMed  CAS  Google Scholar 

  46. Lanas A, Ferrandez A. NSAID-induced gastrointestinal damage: current clinical management and recommendations for prevention. Chin J Dig Dis 2006; 7(3): 127–33

    Article  PubMed  CAS  Google Scholar 

  47. Ji KY, Hu FL. Interaction or relationship between Helicobacter pylori and non-steroidal anti-inflammatory drugs in upper gastrointestinal diseases. World J Gastroenterol 2006; 12(24): 3789–92

    PubMed  CAS  Google Scholar 

  48. Huang J-Q, Sridhar S, Hunt R. Role of Helicobacter pylori infection and non-steroidal anti-inflammatory drugs in peptic ulcer disease: a meta-analysis. Lancet 2002; 359: 14–22

    Article  PubMed  CAS  Google Scholar 

  49. Pilotto A, Franceschi M, Leandro G, et al. The effect of Helicobacter pylori infection on NSAID-related gastrointestinal damage in the elderly. Eur J Gastroenterol Hepatol 1997; 9(10): 951–6

    Article  PubMed  CAS  Google Scholar 

  50. Olbe L, Carlsson E, Lindberg P. A proton-pump inhibitor expedition: the case histories of omeprazole and esomeprazole. Nat Rev Drug Discov 2003; 2(2): 132–9

    Article  PubMed  CAS  Google Scholar 

  51. Handa O, Yoshida N, Fujita N, et al. Molecular mechanisms involved in anti-inflammatory effects of proton pump inhibitors. Inflamm Res 2006; 55(11): 476–80

    Article  PubMed  CAS  Google Scholar 

  52. Lapenna D, de Gioia S, Ciofani G, et al. Antioxidant properties of omeprazole. FEBS Lett 1996; 382(1–2): 189–92

    Article  PubMed  CAS  Google Scholar 

  53. Agastya G, West BC, Callahan JM. Omeprazole inhibits phagocytosis and acidification of phagolysosomes of normal human neutrophils in vitro. Immunopharmacol Immunotoxicol 2000; 22(2): 357–72

    Article  PubMed  CAS  Google Scholar 

  54. Suzuki M, Mori M, Miura S, et al. Omeprazole attenuates oxygen-derived free radical production from human neutrophils. Free Radic Biol Med 1996; 21(5): 727–31

    Article  PubMed  CAS  Google Scholar 

  55. Wandall JH. Effects of omeprazole on neutrophil chemotaxis, super oxide production, degranulation, and translocation of cytochrome b-245. Gut 1992; 33(5): 617–21

    Article  PubMed  CAS  Google Scholar 

  56. Becker JC, Grosser N, Waltke C, et al. Beyond gastric acid reduction: proton pump inhibitors induce heme oxygenase-1 in gastric and endothelial cells. Biochem Biophys Res Commun 2006; 345(3): 1014–21

    Article  PubMed  CAS  Google Scholar 

  57. Fornai M, Natale G, Colucci R, et al. Mechanisms of protection by pantoprazole against NSAID-induced gastric mucosal damage. Naunyn Schmiedebergs Arch Pharmacol 2005; 372(1): 79–87

    Article  PubMed  CAS  Google Scholar 

  58. Biswas K, Bandyopadhyay U, Chattopadhyay I, et al. A novel antioxidant and antiapoptotic role of omeprazole to block gastric ulcer through scavenging of hydroxyl radical. J Biol Chem 2003; 278(13): 10993–1001

    Article  PubMed  CAS  Google Scholar 

  59. Koch TR, Petro A, Darrabie M, et al. Effects of esomeprazole magnesium on nonsteroidal anti-inflammatory drug gastropathy. Dig Dis Sci 2005; 50(1): 86–93

    Article  PubMed  CAS  Google Scholar 

  60. Szabo I, Tarnawski AS. Apoptosis in the gastric mucosa: molecular mechanisms, basic and clinical implications. J Physiol Pharmacol 2000; 51(1): 3–15

    PubMed  CAS  Google Scholar 

  61. Villegas I, Martin MJ, La Casa C, et al. Effects of oxicam inhibitors of cyclooxygenase on oxidative stress generation in rat gastric mucosa: a comparative study. Free Radic Res 2002; 36(7): 769–77

    Article  PubMed  CAS  Google Scholar 

  62. Savoye G, Miralles-Barrachina O, Dechelotte P, et al. Low levels of gastric mucosal glutathione during upper gastric bleeding associated with the use of nonsteroidal anti-inflammatory drugs. Eur J Gastroenterol Hepatol 2001; 13(11): 1309–13

    Article  PubMed  CAS  Google Scholar 

  63. Verri M, Natale G, Boschi F, et al. Effects of esomeprazole sodium on glutathione levels in the gastric mucosa of rats treated with indomethacin [abstract]. Gastroenterology 2006; 130Suppl. 2: A270

    Google Scholar 

  64. Schmassmann A, Tarnawski A, Peskar BM, et al. Influence of acid and angiogenesis on kinetics of gastric ulcer healing in rats: interaction with indomethacin. Am J Physiol 1995; 268 (2 Pt 1): G276–85

    PubMed  CAS  Google Scholar 

  65. Koh TJ, Chen D. Gastrin as a growth factor in the gastrointestinal tract. Regul Pept 2000; 93(1–3): 37–44

    Article  PubMed  CAS  Google Scholar 

  66. Ito M, Segami T, Inaguma K, et al. Cimetidine and omeprazole accelerate gastric ulcer healing by an increase in gastrin secretion. Eur J Pharmacol 1994; 263(3): 253–9

    Article  PubMed  CAS  Google Scholar 

  67. Schmassmann A, Reubi JC. Cholecystokinin-B/gastrin receptors enhance wound healing in the rat gastric mucosa. J Clin Invest 2000; 106(8): 1021–9

    Article  PubMed  CAS  Google Scholar 

  68. Hawkey CJ, Talley NJ, Scheiman JM, et al. Maintenance treatment with esomeprazole following initial relief of non-steroidal anti-inflammatory drug-associated upper gastrointestinal symptoms: the NASA2 and SPACE2 studies. Arthritis Res Ther 2007; 9(1): R17–26

    Article  PubMed  Google Scholar 

  69. Goldstein JL, Johanson JF, Suchower LJ, et al. Healing of gastric ulcers with esomeprazole versus ranitidine in patients who continued to receive NSAID therapy: a randomized trial. Am J Gastroenterol 2005; 100(12): 2650–7

    Article  PubMed  CAS  Google Scholar 

  70. Chan FK, Ching JY, Hung LC, et al. Clopidogrel versus aspirin and esomeprazole to prevent recurrent ulcer bleeding. N Engl J Med 2005; 352(3): 238–44

    Article  PubMed  CAS  Google Scholar 

  71. Chan FK, Wong VW, Suen BY. Combination of a cyclo-oxygenase-2 inhibitor and a proton-pump inhibitor for prevention of recurrent ulcer bleeding in patients at very high risk: a double-blind, randomised trial. Lancet 2007; 369: 1621–6

    Article  PubMed  CAS  Google Scholar 

  72. Lai KC, Chu KM, Hui WM, et al. Esomeprazole with aspirin versus clopidogrel for prevention of recurrent gastrointestinal ulcer complications. Clin Gastroenterol Hepatol 2006; 4(7): 860–5

    Article  PubMed  CAS  Google Scholar 

  73. Scheiman JM, Yeomans ND, Talley NJ, et al. Prevention of ulcers by esomeprazole in at-risk patients using non-selective NSAIDs and COX-2 inhibitors. Am J Gastroenterol 2006; 101(4): 701–10

    Article  PubMed  CAS  Google Scholar 

  74. Cryer B. A COX-2-specific inhibitor plus a proton-pump inhibitor: is this a reasonable approach to reduction in NSAIDs’ GI toxicity?. Am J Gastroenterol 2006; 101(4): 711–3

    Article  PubMed  CAS  Google Scholar 

  75. Goldstein JL, Miner Jr PB, Schlesinger PK, et al. Intragastric acid control in non-steroidal anti-inflammatory drug users: comparison of esomeprazole, lansoprazole and pantoprazole. Aliment Pharmacol Ther 2006; 23(8): 1189–96

    Article  PubMed  CAS  Google Scholar 

  76. Miner Jr P, Katz PO, Chen Y, et al. Gastric acid control with esomeprazole, lansoprazole, omeprazole, pantoprazole, and rabeprazole: a five-way crossover study. Am J Gastroenterol 2003; 98(12): 2616–20

    Article  PubMed  CAS  Google Scholar 

  77. Rohss K, Lind T, Wilder-Smith C. Esomeprazole 40mg provides more effective intragastric acid control than lansoprazole 30mg, omeprazole 20mg, pantoprazole 40mg and rabeprazole 20mg in patients with gastro-oesophageal reflux symptoms. Eur J Clin Pharmacol 2004; 60(8): 531–9

    Article  PubMed  Google Scholar 

  78. Edwards SJ, Lind T, Lundell L. Proton pump inhibitors (PPIs) for the healing of reflux oesophagitis: a comparison of esomeprazole with other PPIs. Aliment Pharmacol Ther 2006; 24(5): 743–50

    Article  PubMed  CAS  Google Scholar 

  79. Kahrilas PJ, Falk GW, Johnson DA, et al. Esomeprazole improves healing and symptom resolution as compared with omeprazole in reflux oesophagitis patients: a randomized controlled trial. The Esomeprazole Study Investigators. Aliment Pharmacol Ther 2000; 14(10): 1249–58

    Article  PubMed  CAS  Google Scholar 

  80. Richter JE, Kahrilas PJ, Johanson J, et al. Efficacy and safety of esomeprazole compared with omeprazole in GERD patients with erosive esophagitis: a randomized controlled trial. Esomeprazole Study Investigators. Am J Gastroenterol 2001; 96(3): 656–65

    Article  PubMed  CAS  Google Scholar 

  81. Johnson DA, Benjamin SB, Vakil NB, et al. Esomeprazole once daily for 6 months is an effective therapy for maintaining healed erosive esophagitis and for controlling gastro-esophageal reflux disease symptoms: a randomized, double-blind, placebo-controlled study of efficacy and safety. Am J Gastroenterol 2001; 96(1): 27–34

    Article  PubMed  CAS  Google Scholar 

  82. Vakil NB, Shaker R, Johnson DA, et al. The new proton pump inhibitor esomeprazole is effective as a maintenance therapy in GERD patients with healed erosive oesophagitis: a 6-month, randomized, double-blind, placebo-controlled study of efficacy and safety. Aliment Pharmacol Ther 2001; 15(7): 927–35

    Article  PubMed  CAS  Google Scholar 

  83. Blume H, Donath F, Warnke A, et al. Pharmacokinetic drug interaction profiles of proton pump inhibitors. Drug Saf 2006; 29(9): 769–84

    Article  PubMed  CAS  Google Scholar 

  84. Pilotto A, Franceschi M, Leandro G, et al. NSAID and aspirin use by the elderly in general practice: effect on gastrointestinal symptoms and therapies. Geriatric Gastroenterology Study Group. Drugs Aging 2003; 20(9): 701–10

    Article  PubMed  CAS  Google Scholar 

  85. Robinson M, Horn J. Clinical pharmacology of proton pump inhibitors: what the practising physician needs to know. Drugs 2003; 63(24): 2739–54

    Article  PubMed  CAS  Google Scholar 

  86. Andersson T, Hassan-lin M, Hasselgreen G, et al. Drug interaction studies with esomeprazole, the (s)-isomer of omeprazole. Clin Pharmacokinet 2001; 40: 523–37

    Article  PubMed  CAS  Google Scholar 

  87. Ishizaki T, Horai Y. Cytochrome P450 and the metabolism of proton pump inhibitors: emphasis on rabeprazole. Aliment Pharmacol Ther 1999; 13Suppl. 3: 27–36

    Article  PubMed  CAS  Google Scholar 

  88. Klotz U. Pharmacokinetic considerations in the eradication of Helicobacterpylori. Clin Pharmacokinet 2000; 38(3): 243–70

    Article  PubMed  CAS  Google Scholar 

  89. Humphries TJ, Merritt GJ. Drug interactions with agents used to treat acid-related disease. Aliment Pharmacol Ther 1999; 13Suppl. 3: 18–26

    Article  PubMed  CAS  Google Scholar 

  90. Horai Y, Kimura M, Furuie H, et al. Pharmacodynamic effects and kinetic disposition of rabeprazole in relation to CYP2C19 genotypes. Aliment Pharmacol Ther 2001; 15: 793–803

    Article  PubMed  CAS  Google Scholar 

  91. Miura M, Inoue K, Kagaya H, et al. Influence of rabeprazole and lansoprazole on the pharmacokinetics of tacrolimus in relation to CYP2C19, CYP3A5 and MDR1 polymorphisms in renal transplant recipients. Biopharm Drug Dispos 2007; 28(4): 167–75

    Article  PubMed  CAS  Google Scholar 

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No sources of funding were used to assist in the preparation of this review. The authors have no conflicts of interest that are directly relevant to the content of this review.

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  1. Division of Pharmacology and Chemotherapy, Department of Internal Medicine, University of Pisa, Via Roma, 55, 56126, Pisa, Italy

    Corrado Blandizzi, Marco Tuccori, Rocchina Colucci, Giovanni Gori, Matteo Fornai, Luca Antonioli, Narcisa Ghisu & Mario Del Tacca

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  1. Corrado Blandizzi
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Blandizzi, C., Tuccori, M., Colucci, R. et al. Clinical Efficacy of Esomeprazole in the Prevention and Healing of Gastrointestinal Toxicity Associated with NSAIDs in Elderly Patients. Drugs Aging 25, 197–208 (2008). https://doi.org/10.2165/00002512-200825030-00003

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