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Original Article
- Inflammatory Bowel Diseases
- Effect of acid-reducing agents on clinical relapse in ulcerative colitis with pH-dependent-released 5-aminosalicylic acid: a multicenter retrospective study in Japan
- Yosuke Shimodaira, Kengo Onochi, Kenta Watanabe, So Takahashi, Sho Fukuda, Noboru Watanabe, Shigeto Koizumi, Tamotsu Matsuhashi, Katsunori Iijima
- Intest Res 2021;19(2):225-231. Published online August 18, 2020
- DOI: https://doi.org/10.5217/ir.2020.00023
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Abstract
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ePub - Background/Aims
5-Aminosalicylic acid (5-ASA) is a basic drug for inducing and maintaining remission for ulcerative colitis. One of its formulations has a coating with a pH-dependent degradation that ensures the release 5-ASA at the terminal ileum. No evidence has been shown concerning the effects of proton pump inhibitors (PPIs) or H2 receptor antagonists (H2RAs) on the clinical course of ulcerative colitis patients in remission. The present study assessed the effect of PPIs or H2RAs on the relapse of ulcerative colitis patients in clinical remission maintained by pH-dependent released 5-ASA.
Methods
Ulcerative colitis patients who had been prescribed time- or pH-dependent-released 5-ASA between January 2015 and December 2018 were enrolled in this multicenter retrospective study. The period of remission until relapse occurred was analyzed among the patients taking time-dependent-released 5-ASA or pH-dependent-released 5-ASA with/without PPIs or H2RAs.
Results
One hundred and nineteen patients were analyzed in this study. In the primary endpoint, the relapse rate was higher in patients taking pH-dependent-released 5-ASA and PPIs or H2RAs than in those taking the pH-dependent-released 5-ASA without PPIs or H2RAs, while the relapse rate was similar in patients taking the time-dependent-released 5-ASA with or without PPIs or H2RAs concomitantly. Patients with a short duration of disease and middle-aged patients more frequently showed relapse with PPIs or H2RAs than the other patients.
Conclusions
The coadministration of PPIs or H2RAs affects the clinical course of ulcerative colitis in remission maintained by pH-dependent-released 5-ASA. -
Citations
Citations to this article as recorded by
- Association of Proton Pump Inhibitor and Potassium‐Competitive Acid Blocker Use With Discontinuation and Intolerance of Oral 5‐Aminosalicylic Acid in Patients With Ulcerative Colitis
Shinsuke Otagiri, Takahiro Ito, Keiji Yagisawa, Ayumu Sugitani, Atsuo Maemoto
JGH Open.2026;[Epub] CrossRef - Updates on conventional therapies for inflammatory bowel diseases: 5-aminosalicylates, corticosteroids, immunomodulators, and anti-TNF-α
Jihye Park, Jae Hee Cheon
The Korean Journal of Internal Medicine.2022; 37(5): 895. CrossRef - The insoluble excretion of multi-matrix system mesalazine preparations in patients with ulcerative colitis
Yuichiro Ohtaki, Kan Uchiyama, Hirotaka Kamiya, Eri Moriizumi, Moe Yamada, Yuma Aoki, Toshimune Watanabe, Sachie Kiryu, Shizuka Suzuki, Yoshihiro Matsumoto, Zensho Ito, Toshifumi Ohkusa, Shigeo Koido, Masayuki Saruta
BMC Gastroenterology.2022;[Epub] CrossRef
- Association of Proton Pump Inhibitor and Potassium‐Competitive Acid Blocker Use With Discontinuation and Intolerance of Oral 5‐Aminosalicylic Acid in Patients With Ulcerative Colitis
- 8,973 View
- 272 Download
- 3 Web of Science
- 3 Crossref
Review
- 'Lemonade Legs': Why do Some Patients Get Profound Hypomagnesaemia on Proton-Pump Inhibitors?
- Nathan S. S. Atkinson, D. John M. Reynolds, Simon P. L. Travis
- Intest Res 2015;13(3):227-232. Published online June 9, 2015
- DOI: https://doi.org/10.5217/ir.2015.13.3.227
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Abstract
PDFPubReader
Proton pump inhibitors (PPIs) are widely used though an association with hypomagnesaemia and hypocalcaemia has only been described since 2006. Patients typically present after years of stable dosing with musculoskeletal, neurological or cardiac arrhythmic symptoms, but it is likely that many cases are under-recognised. Magnesium levels resolve rapidly on discontinuation of PPI therapy and hypomagnesaemia recurs rapidly on rechallenge with any agent in the class. The cellular mechanisms of magnesium homeostasis are increasingly being understood, including both passive paracellular absorption through claudins and active transcellular transporters, including the transient receptor potential channels (TRPM6) identified in the intestine and nephron. PPIs may alter luminal pH by modulating pancreatic secretions, affecting non-gastric H+K+ATPase secretion, altering transporter transcription or channel function. A small reduction in intestinal absorption appears pivotal in causing cumulative deficiency. Risk factors have been associated to help identify patients at risk of this effect but clinical vigilance remains necessary for diagnosis.
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Citations
Citations to this article as recorded by- Use of Acid-Suppression Therapy and Odds of Migraine and Severe Headache in the National Health and Nutrition Examination Survey
Margaret Slavin, Cara L. Frankenfeld, Alexander B. Guirguis, Elizabeth K. Seng
Neurology Clinical Practice.2024;[Epub] CrossRef - Magnesium Homeostasis
Aubrey R. Morrison
Clinical Journal of the American Society of Nephrology.2023; 18(7): 969. CrossRef - Risk of urinary stone formation associated to proton pump inhibitors: A systematic review and metanalysis
Rawa Bapir, Kamran Hassan Bhatti, Ahmed Eliwa, Herney Andrés García-Perdomo, Nazim Gherabi, Derek Hennessey, Vittorio Magri, Panagiotis Mourmouris, Adama Ouattara, Gianpaolo Perletti, Joseph Philipraj, Konstantinos Stamatiou, Musliu Adetola Tolani, Lazaro
Archivio Italiano di Urologia e Andrologia.2022; 94(4): 507. CrossRef - An overview of diagnosis and management of drug‐induced hypomagnesemia
George Liamis, Ewout J. Hoorn, Matilda Florentin, Haralampos Milionis
Pharmacology Research & Perspectives.2021;[Epub] CrossRef - Effects of Proton Pump Inhibitors on the Gastrointestinal Microbiota in Gastroesophageal Reflux Disease
Yi-Chao Shi, Shun-Tian Cai, Ya-Ping Tian, Hui-Jun Zhao, Yan-Bing Zhang, Jing Chen, Rong-Rong Ren, Xi Luo, Li-Hua Peng, Gang Sun, Yun-Sheng Yang
Genomics, Proteomics & Bioinformatics.2019; 17(1): 52. CrossRef - Atrial fibrillation and gastrooesophageal reflux disease: association mechanisms, treatment approaches
O. N. Antropova, N. V. Pyrikova, I. V. Osipova
Russian Journal of Cardiology.2019; (7): 103. CrossRef - Do stop me now: gastric acid-reducing drugs following renal transplantation
Ines Held, Rhodri Pyart
Journal of Kidney Care.2018; 3(1): 6. CrossRef - Magnesium homeostasis in cattle: absorption and excretion
Holger Martens, Sabine Leonhard-Marek, Monika Röntgen, Friederike Stumpff
Nutrition Research Reviews.2018; 31(1): 114. CrossRef - A Review of the Novel Application and Potential Adverse Effects of Proton Pump Inhibitors
Li-Yuan Yu, Lu-Ning Sun, Xue-Hui Zhang, Yue-Qi Li, Lei Yu, Zi-Qing-Yun Yuan, Ling Meng, Hong-Wen Zhang, Yong-Qing Wang
Advances in Therapy.2017; 34(5): 1070. CrossRef - Prokinetics for the treatment of functional dyspepsia: Bayesian network meta-analysis
Young Joo Yang, Chang Seok Bang, Gwang Ho Baik, Tae Young Park, Suk Pyo Shin, Ki Tae Suk, Dong Joon Kim
BMC Gastroenterology.2017;[Epub] CrossRef - Proton Pump Inhibitors Should be Used with Caution in Critically Ill Patients to Prevent the Risk of Clostridium difficile Infection
Jung Hwa Min, You Sun Kim
Gut and Liver.2016; 10(4): 493. CrossRef - Impact of Long-Term Proton Pump Inhibitor Therapy on Gut Microbiota in F344 Rats: Pilot Study
Cheol Min Shin, Nayoung Kim, Yong Sung Kim, Ryoung Hee Nam, Ji Hyun Park, Dong Ho Lee, Yeong-Jae Seok, Yeon-Ran Kim, Joo-Hyon Kim, Jung Min Kim, Joo Sung Kim, Hyun Chae Jung
Gut and Liver.2016; 10(6): 896. CrossRef
- Use of Acid-Suppression Therapy and Odds of Migraine and Severe Headache in the National Health and Nutrition Examination Survey
- 11,313 View
- 72 Download
- 12 Web of Science
- 12 Crossref
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