There are many ways to tackle gastroesophageal reflux disease (GERD) with Proton Pump Inhibitors (PPIs) being one of the ways prescribed by medical professionals around the world.
A look at the US market alone from 1999 to 2012 indicates that the long-term use of PPIs by patients for GERD has doubled. Studies have shown that benefits of PPIs outweigh their risks and this effectively means that the positive outcomes of such studies will have a positive impact on the use of PPIs in GERD therapeutics.
According to an American Gastroenterological Association (AGA) Clinical Practice Update published recently in Gastroenterology, the official journal of AGA, there are greater number of benefits of PPIs than their negative outcomes. In line with this finding, AGA has provided best practice advice for the use of PPIs based on expert opinion and relevant publications:
- Patients with GERD and acid-related complications should take a PPI for short-term healing, maintenance of healing and long-term symptom control.
- Patients with uncomplicated GERD who respond to short-term PPIs should subsequently attempt to stop or reduce them. Patients who cannot reduce PPIs should consider ambulatory esophageal pH/impedance monitoring before committing to lifelong PPIs to help distinguish GERD from a functional syndrome.
- Patients with Barrett’s esophagus and symptomatic GERD should take a long-term PPI.
- Asymptomatic patients with Barrett’s esophagus should consider a long-term PPI.
- Patients at high risk for ulcer-related bleeding from NSAIDs should take a PPI, if they continue to take NSAIDs.
- The dose of long-term PPIs should be periodically reevaluated so that the lowest effective PPI dose can be prescribed to manage the condition.
- Long-term PPI users should not routinely use probiotics to prevent infection.
- Long-term PPI users should not routinely raise their intake of calcium, vitamin B12 or magnesium beyond the recommended dietary allowance.
- Long-term PPI users should not routinely screen or monitor bone mineral density, serum creatinine, magnesium or vitamin B12.
- Specific PPI formulations should not be selected based on potential risks.
Proton pump inhibitors accounted for the second largest segment as they are the most commonly prescribed medication for the treatment of acid reflux. Market share of proton pump inhibitors is expected to decline over the forecast period with the loss of patent protection of several leading drugs, such as Nexium and Prilosec, in this segment. On the other hand, Asia Pacific is expected to grow at a fairly high growth rate as compared to other regional markets due to increased adoption of OTC and generic antacids along with rising prevalence of heartburn.