Low-dose intravenous pantoprazole for optimal inhibition of gastric acid in Korean patients
Jung-Hwan Oh
Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, and
Search for more papers by this authorCorresponding Author
Myung-Gyu Choi
Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, and
Dr Myung-Gyu Choi, Division of Gastroenterology, Department of Internal Medicine, Kangnam St Mary's Hospital, 505 Banpo-dong, Seocho-gu, Seoul 137-040, Korea. Email: [email protected]Search for more papers by this authorMi-Sook Dong
School of Life Science and Biotechnology, Korea University, Seoul, Korea
Search for more papers by this authorJae-Myung Park
Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, and
Search for more papers by this authorChang-Nyol Paik
Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, and
Search for more papers by this authorYu-Kyung Cho
Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, and
Search for more papers by this authorJeong-Jo Jeong
Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, and
Search for more papers by this authorIn-Seok Lee
Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, and
Search for more papers by this authorSang-Woo Kim
Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, and
Search for more papers by this authorSok-Won Han
Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, and
Search for more papers by this authorKyu-Yong Choi
Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, and
Search for more papers by this authorIn-Sik Chung
Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, and
Search for more papers by this authorJung-Hwan Oh
Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, and
Search for more papers by this authorCorresponding Author
Myung-Gyu Choi
Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, and
Dr Myung-Gyu Choi, Division of Gastroenterology, Department of Internal Medicine, Kangnam St Mary's Hospital, 505 Banpo-dong, Seocho-gu, Seoul 137-040, Korea. Email: [email protected]Search for more papers by this authorMi-Sook Dong
School of Life Science and Biotechnology, Korea University, Seoul, Korea
Search for more papers by this authorJae-Myung Park
Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, and
Search for more papers by this authorChang-Nyol Paik
Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, and
Search for more papers by this authorYu-Kyung Cho
Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, and
Search for more papers by this authorJeong-Jo Jeong
Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, and
Search for more papers by this authorIn-Seok Lee
Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, and
Search for more papers by this authorSang-Woo Kim
Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, and
Search for more papers by this authorSok-Won Han
Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, and
Search for more papers by this authorKyu-Yong Choi
Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, and
Search for more papers by this authorIn-Sik Chung
Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, and
Search for more papers by this authorAbstract
Background and Aim: Proton-pump inhibitor (PPI) therapy for bleeding ulcers is more efficacious in Asian patients than in non-Asian patients. The aim of this study was to evaluate the efficacy of various doses of pantoprazole on intragastric acidity in Korean patients.
Methods: A prospective randomized study was conducted in 52 patients either with bleeding peptic ulcers after successful endotherapy or who received endoscopic mucosal resection for gastric neoplasms. Patients were randomized into two doses of intravenous pantoprazole: 40 mg q.d. and 40 mg b.i.d. We compared these results with our preliminary study utilizing high-dose pantoprazole (80 mg + 8 mg/h). The potential contribution of CYP2C19 genetic polymorphisms and the presence of Helicobacter pylori were also assessed.
Results: Pantoprazole 40 mg b.i.d. and high-dose pantoprazole demonstrated better inhibition of intragastric acid than pantoprazole q.d. (P < 0.05). The pantoprazole 40 mg q.d. group exhibited significant variations in acid inhibition correlating with CYP2C19 genotype. Median 24 h pH values did not differ significantly between the pantoprazole b.i.d. and high-dose pantoprazole groups, regardless of H. pylori infection status. A median intragastric pH < 6.0 was observed in only three of 28 patients in the 40 mg b.i.d. group; these three patients were extensive metabolizers.
Conclusion: A 40 mg b.i.d. dose of pantoprazole is sufficient to maintain pH > 6.0 in Korean patients, except for patients with extensive metabolizing CYP2C19 genotypes.
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