Survey on Acid Peptic Disorders: Analyzing Prescribing Pattern of PPIs
Abstract
Abstract: Acid peptic disorders (APDs) result from characteristic but overlapping pathogenic mechanisms that involve acid effects on diminished mucosal defense1. Proton pump inhibitors (PPIs) have become a mainstay
in the management of acid peptic disorders (APDs).
Objectives: This survey was aimed to determine the usage profile of different proton pump inhibitors and overall physicians’ opinion about the clinical experience with Adiza (Ilaprazole tablet 10 mg, marketed by Abbott
India Limited) for the treatment of duodenal ulcer in adult.
Methods: This survey was based on the clinical experience of 402 randomly selected physicians (gastroenterologists, gastrosurgeons, consulting physicians and general practitioners) on an aggregate patient basis in
the management of acid-peptic disorders from different parts of India. A data report form (DRF) comprising of various questions was answered by these physicians. The responding physicians answered the DRF of
patients who suffered from acid-peptic disorders and were eligible for PPI therapy. A minimum of 50 patients per physician were evaluated in this survey.
Results: The commonly encountered acid peptic disorders in physicians’ clinical practice were dyspepsia and gastro oesophageal reflux disorder (GORD). 36.6% of physicians observed that GORD is frequently associated
with the breakthrough symptoms especially during night time followed by duodenal ulcer (5%) and gastric ulcer (2.2%). 98.7% of physicians opined that ilaprazole provided a longer term acid suppression as
compared to PPIs with shorter half-lives. 76.7% of physicians’ perceived excellent symptomatic relief, and 73.6% opined excellent tolerability in patients who were prescribed ilaprazole.
Conclusion: This survey indicated that the main shortcomings observed by physicians with currently existing PPIs such as omeprazole, lansoprazole, pantoprazole, esomeprazole, rabeprazole were related to the ineffective
nocturnal acid control and short plasma half-life of PPIs. Physicians opined that ilaprazole displays important advantages in their clinical practice, with regard to better probability of extending the inhibition of
acid secretion over the nocturnal period.
References
2. Mejia A and Kraft WK. Acid peptic diseases: pharmacological approach to treatment. Expert Rev Clin Pharmacol. 2009;2(3):295–314
3. Dutta AK, Chacko A, Balekuduru A, Sahu MK and Gangadharan SK. Time trends in epidemiology of peptic ulcer disease in India over two decades. Indian J Gastroenterol 2012;31(3):111-115
4. Robinson M, Horn J. Clinical pharmacology of proton pump inhibitors: what the practicing physician needs to know. Drugs. 2003;63(24):2739–54.
5. Goldwater R, Lee SM, Chung GJ, Kim DY, Cho KD, Boileau F. A phase I, randomized, parallel placebocontrolled safety, tolerance and pharmacokinetic study of multiple doses of IY-8119 in fasting male volunteers. ASCPT; 1999 March 18–20; San Antonio, Texas.
6. Ang TL and Fock KM. Nocturnal acid breakthrough: Clinical significance and Management. Journal of Gastroenterology and Hepatology 21(2006) Suppl. 5; S125–S128.
7. Fass R. Nocturnal Acid Breakthrough: A Critical Assessment. Hospital Physician 2004:47-52
8. Tytgat GNJ. Are there unmet needs in acid suppression? Best Practice & Research Clinical Gastroenterology 2004;18:67–72
9. Bortoli N, Martinucci I, Giacchino M, Blandizzi C, Marchi S, Savarino V & Savarino E. The pharmacokinetics of ilaprazole for gastro-esophageal reflux treatment. Expert Opin. Drug Metab. Toxicol. (2013) 9(10)
10. Singh VK, Prabhu K, Ponnudurai K, Singh PK. Prescribing pattern of acid suppressants in modern clinical practice - An analysis. Der Pharmacia Sinica, 2011, 2 (3): 67-73
11. Orr W. Nocturnal Acid Breakthrough: Its Physiological Significance and Clinical Relevance. Practical Gastroenterology 2003:19-30.