Document Detail

The effects of high-dose esomeprazole on gastric and oesophageal acid exposure and molecular markers in Barrett's oesophagus.
MedLine Citation:
PMID:  20937048     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Acid reflux is often difficult to control medically.
AIM: To assess the effect of 40 mg twice daily esomeprazole (high-dose) on gastric and oesophageal pH and symptoms, and biomarkers relevant to adenocarcinoma, in patients with Barrett's oesophagus (BO).
METHODS: Eighteen patients, treated with proton pump inhibitors as prescribed by their treating doctor, had their therapy increased to high-dose esomeprazole for 6 months.
RESULTS: At entry into the study, 9/18 patients had excessive 24-h oesophageal acid exposure, and gastric pH remained <4 for >16 h in 8/18. With high-dose esomeprazole, excessive acid exposure occurred in 2/18 patients, and gastric pH <4 was decreased from 38% of overall recording time and 53% of the nocturnal period to 15% and 17%, respectively (P < 0.001). There was a reduction in self-assessed symptoms of heartburn (P = 0.0005) and regurgitation (P < 0.0001), and inflammation and proliferation in the Barrett's mucosa. There was no significant change in p53, MGMT or COX-2 expression, or in aberrant DNA methylation.
CONCLUSIONS: High-dose esomeprazole achieved higher levels of gastric acid suppression and control of oesophageal acid reflux and symptoms, with significant decreases in inflammation and epithelial proliferation. There was no reversal of aberrant DNA methylation.
A Abu-Sneineh; W Tam; M Schoeman; R Fraser; A R Ruszkiewicz; E Smith; P A Drew; J Dent; R H Holloway
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-08-15
Journal Detail:
Title:  Alimentary pharmacology & therapeutics     Volume:  32     ISSN:  1365-2036     ISO Abbreviation:  Aliment. Pharmacol. Ther.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-12     Completed Date:  2011-02-24     Revised Date:  2013-01-07    
Medline Journal Info:
Nlm Unique ID:  8707234     Medline TA:  Aliment Pharmacol Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  1023-30     Citation Subset:  IM    
Copyright Information:
© 2010 Blackwell Publishing Ltd.
Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, SA, Australia.
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MeSH Terms
Anti-Ulcer Agents / administration & dosage,  therapeutic use*
Barrett Esophagus / drug therapy*,  genetics,  physiopathology
Cell Proliferation / drug effects
DNA Methylation
Esomeprazole Sodium / administration & dosage,  therapeutic use*
Esophagus / pathology,  physiology
Hydrogen-Ion Concentration
Middle Aged
Mucous Membrane / cytology,  pathology
Proton Pump Inhibitors / administration & dosage,  therapeutic use*
Proton Pumps / antagonists & inhibitors*
Stomach / physiology
Tumor Suppressor Proteins / analysis
Reg. No./Substance:
0/Anti-Ulcer Agents; 0/Proton Pump Inhibitors; 0/Proton Pumps; 0/Tumor Suppressor Proteins; L2C9GWQ43H/Esomeprazole Sodium

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