PMID- 23452633
OWN - NLM
STAT- MEDLINE
DCOM- 20130819
LR  - 20181202
IS  - 1558-1942 (Electronic)
IS  - 0889-8553 (Linking)
VI  - 42
IP  - 1
DP  - 2013 Mar
TI  - Novel pharmaceutical approaches to reflux disease.
PG  - 93-117
LID - S0889-8553(12)00134-3 [pii]
LID - 10.1016/j.gtc.2012.12.001 [doi]
AB  - Acid suppression, with proton pump inhibitors (PPI), is the mainstay of therapy 
      for reflux disease; despite this, symptoms and injury persist in many patients. 
      Novel approaches have focused on (1) augmenting acid suppression with 
      reformulated current PPIs, new PPIs or new acid pump blockers and (2) preventing 
      reflux with reflux inhibitors. Other strategies to reduce reflux, improve gastric 
      emptying or esophageal clearance, protect the mucosa, or reduce esophageal 
      sensitivity are under investigation alone or in combination with PPIs; however, 
      novel approaches face significant challenges. The safety and efficacy of current 
      PPIs hamper demonstration of clinical superiority for new acid suppressants, and 
      the multifactorial etiology of reflux disease means that monotherapy using a 
      non-acid suppressant is unlikely to match PPI therapy while combination therapy 
      will be superior only if susceptible patients can be identified reliably. 
      Advances will come, not from a 'one size fits all' approach but rather from novel 
      pharmaceuticals allied to novel investigations to permit targeted, personalized 
      reflux therapy.
CI  - Copyright (c) 2013 Elsevier Inc. All rights reserved.
FAU - Dutta, Usha
AU  - Dutta U
AD  - Division of Gastroenterology, Department of Medicine, McMaster University, 1280 
      Main Street West, Hamilton, Ontario L8S 4K1, Canada.
FAU - Armstrong, David
AU  - Armstrong D
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20130105
PL  - United States
TA  - Gastroenterol Clin North Am
JT  - Gastroenterology clinics of North America
JID - 8706257
RN  - 0 (Alginates)
RN  - 0 (GABA-B Receptor Agonists)
RN  - 0 (Hexuronic Acids)
RN  - 0 (Histamine H2 Antagonists)
RN  - 0 (Proton Pump Inhibitors)
RN  - 8A5D83Q4RW (Glucuronic Acid)
RN  - H789N3FKE8 (Baclofen)
SB  - IM
MH  - Alginates/therapeutic use
MH  - Baclofen/therapeutic use
MH  - Drug Therapy, Combination
MH  - GABA-B Receptor Agonists/therapeutic use
MH  - Gastroesophageal Reflux/*drug therapy/physiopathology
MH  - Glucuronic Acid/therapeutic use
MH  - Hexuronic Acids/therapeutic use
MH  - Histamine H2 Antagonists/therapeutic use
MH  - Humans
MH  - Proton Pump Inhibitors/therapeutic use
EDAT- 2013/03/05 06:00
MHDA- 2013/08/21 06:00
CRDT- 2013/03/05 06:00
PHST- 2013/03/05 06:00 [entrez]
PHST- 2013/03/05 06:00 [pubmed]
PHST- 2013/08/21 06:00 [medline]
AID - S0889-8553(12)00134-3 [pii]
AID - 10.1016/j.gtc.2012.12.001 [doi]
PST - ppublish
SO  - Gastroenterol Clin North Am. 2013 Mar;42(1):93-117. doi: 
      10.1016/j.gtc.2012.12.001. Epub 2013 Jan 5.