GI Consult Series 2001 GI Consult Series 2001

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GI Consult Series 2001 GI Consult Series 2001 Wyeth-Ayerst Pharmaceuticals Erosive Gastroesophageal Erosive Gastroesophageal Reflux Disease (GERD) Reflux Disease (GERD) A common disease The most prevalent GI disorder in the western world An acid-peptic disease A syndrome of symptomatic reflux of gastric contents into
the esophagus A significant cause of injury to esophageal mucosa Gastric refluxate contains a variety of esophageal irritants A chronic condition More than 80% of patients relapse within 6 months when
therapy is withdrawn Modlin IM et al. Acid Related Diseases, Biology and Treatment.1998:265-271. Goyal RK. Harrisons Principles of
Internal Medicine. 1998:1588-1596. Mold JW et al. J Am Geriatr Soc. 1987;35:649-659. Prevalence and Level of Discomfort of Prevalence and Level of Discomfort of Nighttime Heartburn Nighttime Heartburn (n = 1,000) The Gallup Organization. May 2000:19-20. 70% experience moderate
to severe discomfort with
nighttime heartburn Severe discomfort is
more likely among adults
with frequent (" 3x/week)
nighttime heartburn Nighttime Heartburn No nighttime heartburn/
dont know Nighttime heartburn 79% 21% Impact of Nighttime Heartburn on Sleep Impact of Nighttime Heartburn on Sleep by Frequency of Heartburn Symptoms by Frequency of Heartburn Symptoms 0 10 20 30 40 50 60 70 80 <Once 1-2X 3X Heartburn Episodes/Week % With Heartburn Kept Awake (n = 453) Woke Up During
Night (n = 454) 44 41 53 54 67 70 The Gallup Organization. May 2000:26-27. Erosive GERD Erosive GERD Presentations in Practice Presentations in Practice Hoarseness Cough, wheezing Asthma-like symptoms Dysphagia Bleeding (including occult) Noncardiac chest pains Esophageal Typical Symptoms Heartburn (nighttime/daytime) Extraesophageal regurgitation Extraesophageal Atypical Symptoms Untreated Complications Peptic stricture Barretts esophagus Esophageal adenocarcinoma Goyal RK. Harrisons Principles of Internal Medicine.14th ed. 1998:1588-1596. Beers MH et al. Merck Manual of
Diagnosis and Therapy. 17th ed.1999:232. Garnett WR et al. Pharmacotherapy.1997;17:938-958. Kahrilas PJ. JAMA.
1996;276:983-988. Relationship of Erosive GERD Relationship of Erosive GERD Symptoms to Meals Symptoms to Meals 0 15 30 45 6:00 AM 8:00 AM 10:00 AM 12:00 PM 2:00 PM 4:00 PM 6:00 PM 8:00 PM 10:00 PM 12:00 AM 2:00 AM 4:00 AM 6:00 AM Breakfast Lunch Dinner Mean hourly number of reflux symptoms (heartburn and acid regurgitation) reported by patients (n=105) in a 24-hour period Time of Day No. of Reflux Symptoms/Hour (Median mealtimes) Johnsson L, et al. Gullet. 1992;2:58-62. GI Consult Series 2001 GI Consult Series 2001 40-mg Delayed-Release Tablets and I.V. for Injection PROTONIX Delayed-Release Tablets are indicated for short-term treatment (up
to 8 weeks) in the healing and symptomatic relief of erosive esophagitis. For
those patients who have not healed after 8 weeks of treatment, an additional 8-
week course of PROTONIX may be considered. PROTONIX is also indicated for maintenance of healing of erosive esophagitis
and reduction in relapse rates of daytime and nighttime heartburn symptoms in
patients with GERD. Controlled studies did not extend beyond 12 months. The most frequently reported adverse events reported as drug-related with
PROTONIX in short-term, domestic and international controlled clinical trials
were headache and diarrhea. Symptomatic response to therapy does not
preclude the presence of gastric malignancy. PROTONIX is contraindicated in
patients with known hypersensitivity to any component of the formulation. Please see full Prescribing Information. PROTONIX PROTONIX