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clopidogrel proton pump

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https://www.readbyqxmd.com/read/28642210/rationale-and-design-for-a-randomized-comparison-of-efficacy-and-safety-between-aspirin-and-clopidogrel-in-atrial-fibrillation-patients-with-low-stroke-risk-cesac-af-trial
#1
Sang Min Park, Haemin Jeong, Mi-Hyang Jung, Kyung Soon Hong, Myeong-Ki Hong, Chang Seok Bang, Christopher Y Kim
BACKGROUND: Atrial fibrillation (AF) increases the risk of thromboembolic stroke. An oral anticoagulant should be administrated to prevent stroke in patients with moderate stroke risk (ie, CHA2DS2-VASc score>2). If the stroke risk is low (i.e. the score=1), however, antiplatelet agent such as aspirin is widely used. Aspirin can cause peptic ulcer disease (PUD) while its alternative, clopidogrel, theoretically does not. OBJECTIVE: To elucidate the efficacy and safety between aspirin and clopidogrel, a multicenter randomized controlled trial was designed in AF patients with low stroke risk...
June 19, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28603135/report-impact-of-drug-combination-of-clopidogrel-and-pantoprazole-in-the-prognosis-of-patients-with-transient-ischemic-attack
#2
Min Lu
The study aimed to investigate the impact of clopidogrel combined with proton pump inhibitors (PPI) pantoprazole treatment on the prognosis of patients with transient ischemic attack (TIA). A total of 478 cases of TIA patients treated with clopidogrel were randomly assigned half to clopidogrel combined with pantoprazole treatment and the control groups (clopidogrel treatment alone) from January 2012 to January 20l4. The platelet aggregation before and after treatment and cerebrovascular events incidence within 90 days were compared and analyzed...
January 2017: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28576397/the-contribution-of-clinical-and-pathological-predisposing-factors-to-severe-gastro-duodenal-lesions-in-patients-with-long-term-low-dose-aspirin-and-proton-pump-inhibitor-therapy
#3
Anca Negovan, Mihaela Iancu, Valeriu Moldovan, Kinga Sàrkàny, Simona Bataga, Simona Mocan, Ioan Țilea, Claudia Banescu
BACKGROUND: Preventive strategies developed to avoid the complications of antiplatelet therapies recommend the evaluation of risk factors for gastrointestinal events and indicated gastroprotective strategies. AIM: We aimed to assess the impact of predisposing factors - histological findings, concomitant drug consumption, comorbidities, symptoms, social habits, Helicobacter pylori infection - on severe gastro-duodenal lesions in patients with low-dose aspirin and concomitant protective therapy with proton pump inhibitors (PPI)...
May 30, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28547741/decrease-in-switches-to-unsafe-proton-pump-inhibitors-after-communications-about-interactions-with-clopidogrel
#4
Willemien J Kruik-Kollöffel, Job van der Palen, Myrthe P P van Herk-Sukel, H Joost Kruik, Kris L L Movig
BACKGROUND: In 2009 and 2010 medicines regulatory agencies published official safety statements regarding the concomitant use of proton pump inhibitors and clopidogrel. We wanted to investigate a change in prescription behaviour in prevalent gastroprotective drug users (2008-2011). METHODS: Data on drug use were retrieved from the Out-patient Pharmacy Database of the PHARMO Database Network. We used interrupted time series analyses (ITS) to estimate the impact of each safety statement on the number of gastroprotective drug switches around the start of clopidogrel and during clopidogrel use...
May 25, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28449186/the-risk-of-lower-gastrointestinal-bleeding-in-low-dose-aspirin-users
#5
W-C Chen, K-H Lin, Y-T Huang, T-J Tsai, W-C Sun, S-K Chuah, D-C Wu, P-I Hsu
BACKGROUND: Aspirin increases the risk of gastrointestinal bleeding. AIM: To investigate the risk of lower gastrointestinal bleeding (LGIB) in aspirin users. METHODS: Low-dose (75-325 mg daily) aspirin users and controls matched by age, gender and enrollment time in a 1:5 ratio were selected from 1 million randomly sampled subjects in the National Health Insurance Research Database of Taiwan. Cox proportional hazard regression models were developed to evaluate the predictors of LGIB with adjustments for age, gender, comorbidities including coronary artery disease, ischaemic stroke, diabetes, hypertension, chronic kidney disease, liver cirrhosis, chronic obstructive pulmonary disease, dyslipidemia, uncomplicated peptic ulcer disease, history of peptic ulcer bleeding, and concomitant use of clopidogrel, ticlopidine, warfarin, nonsteroidal anti-inflammatory drugs (NSAIDs), cyclooxygenase-2 inhibitors, steroids, proton pump inhibitors (PPIs), histamine-2 receptor antagonists (H2RAs), nitrates, alendronate, selective serotonin reuptake inhibitors (SSRIs) and calcium channel blockers...
April 27, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28395507/pantoprazole-does-not-reduce-the-antiplatelet-effect-of-clopidogrel-a-randomized-controlled-trial-in-korea
#6
Yoon Jin Choi, Nayoung Kim, In-Jin Jang, Joo-Youn Cho, Ryoung Hee Nam, Ji Hyun Park, Hyun Jin Jo, Hyuk Yoon, Cheol Min Shin, Young Soo Park, Dong Ho Lee, Hyun Chae Jung
Background/Aims: Concerns that proton pump inhibitors (PPIs) diminish the efficacy of clopidogrel could hamper the appropriate prescription of PPIs. We evaluated the influence of pantoprazole on the antiplatelet effect of clopidogrel compared with ranitidine, which is regarded as safe, after stratification of the population according to the presence of a cytochrome (CYP) 2C19 polymorphism in Korea. Methods: Forty patients who underwent dual antiplatelet therapy were randomized to receive pantoprazole (n=20) or ranitidine (n=20)...
April 11, 2017: Gut and Liver
https://www.readbyqxmd.com/read/28392699/comparison-of-prophylactic-effect-of-ugib-and-effects-on-platelet-function-between-ppis-and-h2ras-combined-with-dapt-systematic-review-and-meta-analysis
#7
Zhan-Miao Yi, Ting-Ting Qiu, Yuan Zhang, Zhi-Yan Liu, Suo-Di Zhai
OBJECTIVE: We compared prophylactic effects of proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2RAs) on upper gastrointestinal bleeding (UGIB) associated with dual antiplatelet therapy (DAPT) and explored this influence on platelet function. METHODS: Randomized controlled trials and cohort studies comparing PPIs with H2RAs in adults receiving DAPT were collected from PubMed, EMBASE and Cochrane databases. Dichotomous data were pooled to obtain risk ratios (RRs) for UGIB, major adverse cardiovascular events (MACEs), poor responders to clopidogrel and rehospitalization, and continuous data were pooled to obtain mean differences (MDs) for P2Y12 reaction units (PRUs), with 95% confidence intervals (CIs)...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28346068/institutional-profile-university-of-florida-health-personalized-medicine-program
#8
Larisa H Cavallari, Kristin W Weitzel, Amanda R Elsey, Xinyue Liu, Scott A Mosley, Donald M Smith, Benjamin J Staley, Almut G Winterstein, Carol A Mathews, Francesco Franchi, Fabiana Rollini, Dominick J Angiolillo, Petr Starostik, Michael J Clare-Salzler, David R Nelson, Julie A Johnson
The University of Florida (UF) Health Personalized Medicine Program launched in 2012 with CYP2C19 genotyping for clopidogrel response at UF Health Shands Hospital. We have since expanded CYP2C19 genotyping to UF Health Jacksonville and established the infrastructure at UF Health to support clinical implementation for five additional gene-drug pairs: TPMT-thiopurines, IFNL3 (IL28B)-PEG IFN-α-based regimens, CYP2D6-opioids, CYP2D6/CYP2C19-antidepressants and CYP2C19-proton pump inhibitors. We are contributing to the evidence based on outcomes with genotype-guided therapy through pragmatic studies of our clinical implementations...
April 2017: Pharmacogenomics
https://www.readbyqxmd.com/read/28321021/potential-cardiovascular-risks-of-proton-pump-inhibitors-in-the-general-population
#9
REVIEW
Wengen Zhu, Kui Hong
Proton pump inhibitors (PPIs) are the most effective gastric acid-suppressing agents and the mainstay medical therapy for a series of acid peptic diseases. In general, the safety profile of PPIs is excellent. However, with long-term drug administration, the safety and potency of PPIs has been questioned. In the cardiovascular field, drug-drug interactions related to PPIs have been identified with particular attention regarding the use of PPIs combined with clopidogrel in patients with acute coronary syndrome...
April 6, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28145783/the-budget-impact-of-using-enteric-coated-aspirin-325%C3%A2-mg%C3%A2-%C3%A2-immediate-release-omeprazole-40%C3%A2-mg-to-prevent-recurrent-cardiovascular-events
#10
Wenjie Zhang, Yi Han, John G Fort, David Schofield, James P Tursi
OBJECTIVE: Aspirin (acetylsalicylic acid; ASA) is commonly used for secondary prevention of cardiovascular (CV) events, but may be associated with gastrointestinal (GI) adverse events, which can reduce adherence. Use of ASA co-therapy with proton pump inhibitors in patients at risk may be suboptimal. PA32540 (Yosprala™) is a coordinated-delivery tablet combining EC-ASA 325 mg and immediate-release omeprazole 40 mg. The objective of this flexible budget impact model was to project the financial consequences of introducing PA32540 325 mg/40 mg to prevent recurrent CV events, while reducing ASA-associated GI events in US adults...
February 23, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28130652/clinical-implications-of-emerging-data-on-the-safety-of-proton-pump-inhibitors
#11
REVIEW
Felice Schnoll-Sussman, Philip O Katz
Proton pump inhibitors (PPI) are among the safest class of drugs used by all care providers, including gastroenterologists. They are the mainstay in treatment of acid-related disease, in particular, gastroesophageal reflux disease. Without them, many patients would experience a major decrement in their quality of life. However, no drug is without side effects or adverse events. In the past decade, numerous reports, principally case control studies and meta-analyses, have raised questions about important adverse events related to the use of PPIs...
March 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28116095/prescription-behavior-for-gastroprotective-drugs-in-new-users-as-a-result-of-communications-regarding-clopidogrel-proton-pump-inhibitor-interaction
#12
Willemien J Kruik-Kollöffel, Job van der Palen, H Joost Kruik, Myrthe P P van Herk-Sukel, Kris L L Movig
Safety concerns of the concomitant use of clopidogrel and proton pump inhibitors (PPIs) were published in 2009 and 2010 by the medicines regulatory agencies, including a direct healthcare professional communication. We examined the association between various safety statements and prescription behavior for gastroprotective drugs in naïve patients in the Netherlands during the years 2008-2011. Data from the PHARMO Database Network were analyzed with interrupted time series analyses to estimate the impact of each communication on drug prescriptions...
August 2016: Pharmacology Research & Perspectives
https://www.readbyqxmd.com/read/28103324/use-of-proton-pump-inhibitors-predicts-heart-failure-and-death-in-patients-with-coronary-artery-disease
#13
Ana María Pello Lázaro, Carmen Cristóbal, Juan Antonio Franco-Peláez, Nieves Tarín, Álvaro Aceña, Rocío Carda, Ana Huelmos, María Luisa Martín-Mariscal, Jesús Fuentes-Antras, Juan Martínez-Millá, Joaquín Alonso, Óscar Lorenzo, Jesús Egido, Lorenzo López-Bescós, José Tuñón
OBJECTIVES: Proton-pump inhibitors (PPIs) seem to increase the incidence of cardiovascular events in patients with coronary artery disease (CAD), mainly in those using clopidogrel. We analysed the impact of PPIs on the prognosis of patients with stable CAD. METHODS: We followed 706 patients with CAD. Primary outcome was the combination of secondary outcomes. Secondary outcomes were 1) acute ischaemic events (any acute coronary syndrome, stroke, or transient ischaemic attack) and 2) heart failure (HF) or death...
2017: PloS One
https://www.readbyqxmd.com/read/28056809/is-the-concomitant-use-of-clopidogrel-and-proton-pump-inhibitors-still-associated-with-increased-adverse-cardiovascular-outcomes-following-coronary-angioplasty-a-systematic-review-and-meta-analysis-of-recently-published-studies-2012-2016
#14
Pravesh Kumar Bundhun, Abhishek Rishikesh Teeluck, Akash Bhurtu, Wei-Qiang Huang
BACKGROUND: Controversies were previously observed with the concomitant use of clopidogrel and Proton Pump Inhibitors (PPIs), especially omeprazole, following coronary angioplasty. Even though several studies showed no interaction between clopidogrel and PPIs, questions have been raised about the decrease in antiplatelet effects of clopidogrel with PPIs. A previously published meta-analysis showed concomitant use of clopidogrel and PPIs to be associated with higher adverse cardiovascular outcomes...
January 5, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28024166/an-east-asian-perspective-on-the-interaction-between-proton-pump-inhibitors-and-clopidogrel
#15
Duowu Zou, Khean-Lee Goh
Both proton pump inhibitors (PPIs) and clopidogrel are widely prescribed in the Asia-Pacific population. PPIs are the mainstay therapeutic agents for prophylaxis against aspirin gastropathy and for ARDs (Acid Related Disorders) including gastroesophageal reflux disease (GERD). They are also co-prescribed with oral anticoagulant agents (OAAs)and with dual-antiplatelet therapy (DAPT) for the treatment and prevention of gastrointestinal (GI) bleeding. Clopidogrel belongs to the drug class of thienopyridines, and is currently the most widely prescribed OAA either alone or in combination with aspirin...
December 26, 2016: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/27991432/the-effect-of-proton-pump-inhibitors-on-the-cyp2c19-enzyme-activity-evaluated-by-the-pantoprazole-13-c-breath-test-in-gerd-patients-clinical-relevance-for-personalized-medicine
#16
Anil S Modak, Iryna Klyarytska, Valerij Kriviy, Tatjana Tsapyak, Yliya Rabotyagova
Patients with gastroesophageal reflux disease (GERD) are routinely prescribed one of the six FDA approved proton pump inhibitors (PPI). All of these PPI are inhibitors of CYP2C19 enzyme to varying degrees. The phenotype pantoprazole-(13)C breath test (Ptz-BT) was used to identify patients who are poor metabolizers (PM) and the extent of phenoconversion of CYP2C19 enzyme activity caused by four PPI (omeprazole, esomprazole pantoprazole and rabeprazole) in 54 newly diagnosed GERD patients prior to initiating randomly selected PPI therapy and 30 d after PPI therapy...
December 17, 2016: Journal of Breath Research
https://www.readbyqxmd.com/read/27981489/influence-of-low-dose-proton-pump-inhibitors-administered-concomitantly-or-separately-on-the-anti-platelet-function-of-clopidogrel
#17
Takahisa Furuta, Mitsushige Sugimoto, Chise Kodaira, Masafumi Nishino, Mihoko Yamade, Takahiro Uotani, Shu Sahara, Hitomi Ichikawa, Takuma Kagami, Moriya Iwaizumi, Yasushi Hamaya, Satoshi Osawa, Ken Sugimoto, Kazuo Umemura
Proton pump inhibitors (PPIs) at low doses can effectively prevent gastrointestinal bleeding due to aspirin and are widely used in Japan for gastroprotection in patients taking anti-platelet agents. We examined the influence of different PPIs at low doses administered concomitantly or separately on anti-platelet functions of clopidogrel. In 41 healthy Japanese volunteers with different CYP2C19 genotypes who took clopidogrel 75 mg in the morning alone, or with omeprazole 10 mg, esomeprazole 10 mg, lansoprazole 15 mg, or rabeprazole 10 mg, either concomitantly in the morning or separately in the evening, we measured the inhibition of platelet aggregation (IPA, %) using VerifyNow P2Y12 assay at 4 h after the last clopidogrel dose on Day 7 of each regimen...
April 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/27922030/histamine-2-receptor-antagonist-cannot-prevent-recurrent-peptic-ulcers-in-patients-with-atherosclerotic-diseases-who-receive-platelet-adp-receptor-antagonist-monotherapy-a-randomized-controlled-double-blind-and-double-dummy-trial
#18
RANDOMIZED CONTROLLED TRIAL
Ping-I Hsu, Deng-Chyang Wu, Feng-Woei Tsay, Jin-Shiung Cheng, Chun-Peng Liu, Kwok-Hung Lai, Wen-Chi Chen, Huay-Min Wang, Tzung-Jiun Tsai, Kuo-Wang Tsai, Sung-Shuo Kao
OBJECTIVES: Proton pump inhibitor can effectively prevent recurrent peptic ulcers among atherosclerotic patients receiving clopidogrel monotherapy. However, the interaction between proton pump inhibitors and clopidogrel has raised concerns over the safety of combined use of the two medicines in clinical practice. The aims of this randomized-controlled, double-blind and double-dummy trial were to investigate the efficacy of histamine-2 receptor antagonist (H2RA) in the prevention of recurrent peptic ulcer in patients undergoing thienopyridine monotherapy...
February 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27882086/effects-of-the-short-term-application-of-pantoprazole-combined-with-aspirin-and-clopidogrel-in-the-treatment-of-acute-stemi
#19
Peng Wei, Yi-Gang Zhang, Lin Ling, Zi-Qi Tao, Li-Ya Ji, Jie Bai, Bin Zong, Chun-Ying Jiang, Qian Zhang, Qiang Fu, Xiang-Jun Yang
The aim of the present study was to determine the effects of the short-term application of pantoprazole on the co-treatment of acute ST-segment elevation myocardial infarction (STEMI) with aspirin and clopidogrel. A total of 207 acute patients showing primary symptoms of STEMI, who received successful emergent percutaneous coronary intervention treatment during hospitalization were randomly divided into two groups. In the test group proton pump inhibitors (PPIs), the patients were treated with a combination of aspirin and clopidogrel and pantoprazole, while those in the control group were treated only with aspirin and clopidogrel...
November 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27808485/concomitant-use-of-proton-pump-inhibitors-and-dual-antiplatelet-therapy-for-cardiovascular-outcomes
#20
Alessandro Mandurino-Mirizzi, Sergio Leonardi, Chiara Melloni
INTRODUCTION: The aim of this review is to discuss the consequences of potential pharmacokinetic interactions between proton pump inhibitors (PPIs) and antiplatelet therapy on cardiovascular (CV) outcomes and provide guidance on the management of concomitant use of PPIs in patients on dual antiplatelet therapy (DAPT). EVIDENCE ACQUISITION: DAPT combining aspirin and oral P2Y12 receptor inhibitors increases the risk of gastrointestinal (GI) bleeding, with higher rates of morbidity and mortality in patients undergoing percutaneous coronary intervention (PCI)...
November 3, 2016: Minerva Endocrinologica
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