PPIs and Risk for Community-Acquired Pneumonia
General Medicine Summary and Comment
Current PPI use — especially recently initiated use — was associated with higher risk.
By Jamaluddin Moloo, MD, MPH
May 31, 2007
Covering:
Gulmez SE et al., Arch Intern Med 2007 May 14; 167:950-5
In High-Risk Patients, Adding a PPI to Celecoxib Improves GI Safety
General Medicine Summary and Comment
In a randomized trial, there was no recurrence of upper GI ulcer bleeding among those whose regimens included a PPI.
By Bruce Soloway, MD
May 29, 2007
Covering:
Chan FKL et al., Lancet 2007 May 12; 369:1621-6
Scheiman JM and Fendrick AM., Lancet 2007 May 12; 369:1580-1
Do PPIs Increase Risk for CAP?
Infectious Diseases Summary and Comment
In a large population-based case-control study, the use of proton-pump inhibitors was associated with increased risk for community-acquired pneumonia.
By Daniel J. Diekema, MD, MS
May 23, 2007
Covering:
Gulmez SE et al., Arch Intern Med 2007 May 14; 167:950-5
GERD and Sleep Disturbance
Gastroenterology Summary and Comment
Free
Nonacid reflux events might explain refractory sleep disturbance during PPI therapy.
By David A. Johnson, MD
May 18, 2007
Covering:
Orr WC et al., Chest 2007 Feb; 131:460-5
Upper GI Complications with Coxibs or Nonselective NSAIDs
Gastroenterology Summary and Comment
Free
In a subgroup of patients who did not take aspirin, coxibs were associated with significantly lower risk for UGI complications than were nonselective NSAIDs.
By David J. Bjorkman, MD, MSPH (HSA), SM (Epid.)
May 11, 2007
Covering:
García Rodríguez LA and Barreales Tolosa L., Gastroenterology 2007 Feb; 132:498-506
Peptic Ulcers and Bleeding with Rofecoxib
Gastroenterology Summary and Comment
Should the availability of coxibs be reevaluated?
By David J. Bjorkman, MD, MSPH (HSA), SM (Epid.)
May 11, 2007
Covering:
Lanas A et al., Gastroenterology 2007 Feb; 132:490-7
Dual Therapy or Monotherapy for Bleeding Peptic Ulcers?
Gastroenterology Summary and Comment
Free
Injection therapy should be followed by thermal or mechanical therapy.
By David J. Bjorkman, MD, MSPH (HSA), SM (Epid.)
May 4, 2007
Covering:
Marmo R et al., Am J Gastroenterol 2007 Feb; 102:279-89
Omeprazole Before Endoscopy in Patients with Upper GI Bleeding
General Medicine Summary and Comment
Free
Active bleeding from peptic ulcers at endoscopy was noted less frequently among omeprazole recipients than among placebo recipients.
By Allan S. Brett, MD
April 18, 2007
Covering:
Lau JY et al., N Engl J Med 2007 Apr 19; 356:1631-40
Intravenous PPI Therapy Before Endoscopy for UGI Bleeding
Gastroenterology Summary and Comment
Free
Early omeprazole therapy lowered the prevalence of high-risk stigmata, but it did not affect other clinical outcomes.
By David J. Bjorkman, MD, MSPH (HSA), SM (Epid.)
April 18, 2007
Covering:
Lau JY et al., N Engl J Med 2007 Apr 19; 356:1631-40
Poor Correlation Between Reflux Esophagitis and Laryngeal Lesions
General Medicine Summary and Comment
At 9 of 10 sites in the larynx and pharynx, abnormalities did not differ between GERD patients and controls.
By Allan S. Brett, MD
April 17, 2007
Covering:
Vavricka SR et al., Am J Gastroenterol 2007 Apr; 102:716-22
Vaezi MF., Am J Gastroenterol 2007 Apr; 102:723-4
Gastroesophageal Reflux After PEG
Gastroenterology Summary and Comment
Hiatal hernia and severe erosive esophagitis are risk factors for GER in elders with PEG feeding tubes.
By David A. Johnson, MD
March 30, 2007
Covering:
Nishiwaki S et al., Gastrointest Endosc 2006 Dec; 64:890-6
Effect of Aspirin on NSAID-Associated Ulcer Bleeding
Gastroenterology Summary and Comment
Free
Using low-dose aspirin concomitantly with coxibs negates coxibs’ benefit for lower bleeding risk.
By David J. Bjorkman, MD, MSPH (HSA), SM (Epid.)
March 30, 2007
Covering:
Lanas A et al., Gut 2006 Dec; 55:1731-8
Trends in Acute Nonvariceal Upper Gastrointestinal Bleeding
Gastroenterology Summary and Comment
During a 10-year period (1993–2003), the rate of hospitalization for UGIB decreased significantly in this Canadian population.
By David J. Bjorkman, MD, MSPH (HSA), SM (Epid.)
March 16, 2007
Covering:
Targownik LE and Nabalamba A., Clin Gastroenterol Hepatol 2006 Dec; 4:1459-66
GI Complications with COX-2 Inhibitors
General Medicine Summary and Comment
Free
Two studies add to the growing body of evidence that risk is increased with these drugs.
By Allan S. Brett, MD
March 15, 2007
Covering:
García Rodríguez LA and Barreales Tolosa L., Gastroenterology 2007 Feb; 132:498-506
Lanas A et al., Gastroenterology 2007 Feb; 132:490-7
Adherence to Gastroprotective Therapy Limits NSAID-Associated Ulcer Complications
Gastroenterology Summary and Comment
Free
Among patients who receive nonselective NSAIDs, adherence to gastroprotective therapy will lower the rate of ulcer complications.
By David J. Bjorkman, MD, MSPH (HSA), SM (Epid.)
March 2, 2007
Covering:
Goldstein JL et al., Clin Gastroenterol Hepatol 2006 Nov; 4:1337-45
Outcome of Upper GI Bleeding in NSAID Users
Gastroenterology Summary and Comment
Current NSAID use was associated with increased 30-day mortality risk in a Danish study, but confounding could explain some of the observed relation.
By David J. Bjorkman, MD, MSPH (HSA), SM (Epid.)
March 2, 2007
Covering:
Thomsen RW et al., Aliment Pharmacol Ther 2006 Nov 15; 24:1431-8
Proton-Pump Inhibitors and Fundic-Gland Polyps
Gastroenterology Summary and Comment
Free
Long-term PPI use increases risk for fundic-gland polyps, but such polyps have little clinical significance.
By David J. Bjorkman, MD, MSPH (HSA), SM (Epid.)
February 23, 2007
Covering:
Jalving M et al., Aliment Pharmacol Ther 2006 Nov 1; 24:1341-8
Acid Suppression and Subsequent Gastric or Esophageal Cancer
Gastroenterology Summary and Comment
Underlying indications for acid-suppression therapy, rather than the therapy itself, are related to risk for subsequent cancer.
By David J. Bjorkman, MD, MSPH (HSA), SM (Epid.)
February 23, 2007
Covering:
García Rodríguez LA et al., Gut 2006 Nov; 55:1538-44
Gastroprotection with a New COX-2 Inhibitor: Clinically Significant?
General Medicine Summary and Comment
In a secondary analysis of results from earlier trials, etoricoxib had little clinical GI benefit over diclofenac.
By Bruce Soloway, MD
February 21, 2007
Covering:
Laine L et al., Lancet 2007 Feb 10; 369:465-73
Drenth JPH and Verheugt FW., Lancet 2007 Feb 10; 369:439-40
How Valuable Is the PPI Test for Diagnosing GERD?
Gastroenterology Summary and Comment
Free
Measuring symptom response to empirical PPI therapy is of little value in distinguishing primary care patients who have GERD.
By David J. Bjorkman, MD, MSPH (HSA), SM (Epid.)
February 9, 2007
Covering:
Aanen MC et al., Aliment Pharmacol Ther 2006 Nov 1; 24:1377-84
Pre-Procedure PPI Therapy for Acute Nonvariceal Upper GI Bleeding
Gastroenterology Summary and Comment
The role of routine pre-endoscopy PPI therapy in patients with UGIB cannot be determined based on currently available data.
By David J. Bjorkman, MD, MSPH (HSA), SM (Epid.)
February 9, 2007
Covering:
Keyvani L et al., Aliment Pharmacol Ther 2006 Oct 15; 24:1247-55
Not Much Support for PPIs in Treating Respiratory Symptoms
Several studies challenge the use of PPIs to treat asthma, cough, or hoarseness.
By Allan S. Brett, MD
December 28, 2006
Reactive Oxygen Species in BE and Adenocarcinoma Cells
Gastroenterology Summary and Comment
Free
Aggressive acid suppression in BE patients is supported by new findings on the mechanism of acid-induced progression to cancer.
By David A. Johnson, MD
December 1, 2006
Covering:
Fu X et al., J Biol Chem 2006 Jul 21; 281:20368-82
Does GERD Increase Risk for Laryngeal Cancer?
Gastroenterology Summary and Comment
The growing prevalence of GERD in the U.S. might wash out benefits gained from declines in smoking.
By David A. Johnson, MD
December 1, 2006
Covering:
Vaezi MF et al., Am J Med 2006 Sep; 119:768-76
Antithrombotic Therapy and Risk for Upper GI Bleeding
General Medicine Summary and Comment
The risk associated with combination therapy is high.
By Keith I. Marton, MD
November 30, 2006
Covering:
Hallas J et al., BMJ 2006 Oct 7; 333:726-8
Sung JJY., BMJ 2006 Oct 7; 333:712-3
