PMID- 19686407 OWN - NLM STAT- MEDLINE DCOM- 20091211 LR - 20221207 IS - 1440-1746 (Electronic) IS - 0815-9319 (Linking) VI - 24 IP - 10 DP - 2009 Oct TI - Optimal dose of intravenous pantoprazole in patients with peptic ulcer bleeding requiring endoscopic hemostasis in Korea. PG - 1617-24 LID - 10.1111/j.1440-1746.2009.05939.x [doi] AB - 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. FAU - Choi, Kee Don AU - Choi KD AD - Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. FAU - Kim, Nayoung AU - Kim N FAU - Jang, In-Jin AU - Jang IJ FAU - Park, Young Soo AU - Park YS FAU - Cho, Joo Youn AU - Cho JY FAU - Kim, Jung-Ryul AU - Kim JR FAU - Shin, Jai Moo AU - Shin JM FAU - Jung, Hyun Chae AU - Jung HC FAU - Song, In Sung AU - Song IS LA - eng PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20090803 PL - Australia TA - J Gastroenterol Hepatol JT - Journal of gastroenterology and hepatology JID - 8607909 RN - 0 (2-Pyridinylmethylsulfinylbenzimidazoles) RN - 0 (Anti-Ulcer Agents) RN - 0 (Proton Pump Inhibitors) RN - D8TST4O562 (Pantoprazole) RN - EC 1.14.14.1 (Aryl Hydrocarbon Hydroxylases) RN - EC 1.14.14.1 (CYP2C19 protein, human) RN - EC 1.14.14.1 (Cytochrome P-450 CYP2C19) SB - IM MH - 2-Pyridinylmethylsulfinylbenzimidazoles/*administration & dosage/pharmacokinetics MH - Adult MH - Aged MH - Anti-Ulcer Agents/*administration & dosage/pharmacokinetics MH - Aryl Hydrocarbon Hydroxylases/genetics MH - Asian People MH - Cytochrome P-450 CYP2C19 MH - *Endoscopy, Gastrointestinal MH - Female MH - Gastric Acidity Determination MH - Helicobacter pylori/isolation & purification MH - *Hemostatic Techniques MH - Humans MH - Infusions, Intravenous MH - Injections, Intravenous MH - Korea/epidemiology MH - Male MH - Middle Aged MH - Pantoprazole MH - Peptic Ulcer/*drug therapy/ethnology/microbiology MH - Peptic Ulcer Hemorrhage/ethnology/microbiology/prevention & control/*therapy MH - Polymorphism, Genetic MH - Proton Pump Inhibitors/*administration & dosage/pharmacokinetics MH - Secondary Prevention MH - Treatment Outcome EDAT- 2009/08/19 09:00 MHDA- 2009/12/16 06:00 CRDT- 2009/08/19 09:00 PHST- 2009/08/19 09:00 [entrez] PHST- 2009/08/19 09:00 [pubmed] PHST- 2009/12/16 06:00 [medline] AID - JGH5939 [pii] AID - 10.1111/j.1440-1746.2009.05939.x [doi] PST - ppublish SO - J Gastroenterol Hepatol. 2009 Oct;24(10):1617-24. doi: 10.1111/j.1440-1746.2009.05939.x. Epub 2009 Aug 3.