medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2018-3-32-41medsovet-2451Research ArticleЗАБОЛЕВАНИЯ ПИЩЕВОДА И ЖЕЛУДКАESOPHAGEAL AND GASTRIC DISEASESСтратегия выбора ингибитора протонной помпы нового поколения декслансопразола в терапии гастроэзофагеальной рефлюксной болезниThe strategy for choosing a new-generation proton pump inhibitor dexlansoprazole in the treatment of gastroesophageal reflux diseaseТопчийН. В.TopchiyN. V.

к.м.н.

PhD in medicine

ТопорковА. С.ToporkovA. S.

к.м.н.

PhD in medicine

Российская медицинская академия непрерывного профессионального образования; Ассоциация врачей общей практики (семейных врачей) РФ; Российская гастроэнтерологическая ассоциация, МоскваРоссияRussian Medical Academy of Continuing Postgraduate Education; Association of General Practitioners (Family Physicians) of the Russian Federation Russian Gastroenterological AssociationRussian Federation201819042018033241Copyright © Топчий Н.В., Топорков А.С., 20182018Топчий Н.В., Топорков А.С.Topchiy N.V., Toporkov A.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/2451

Гибкость дозирования в сочетании с увеличением продолжительности поддержания терапевтической концентрации в плазме декслансопразола с модифицированным высвобождением и длительным подавлением секреции кислоты после приема препарата позволяет предположить, что декслансопразол обладает рядом преимуществ для пациентов с кислотозависимыми заболеваниями. Фармакокинетический профиль декслансопразола характеризуется наличием двух пиков Тmax через 1–2 и 4–5 ч после приема препарата и обеспечивает устойчивую концентрацию его в крови. Эффективность декслансопразола в рамках терапии различных форм гастроэзофагеальной рефлюксной болезни была подтверждена несколькими рандомизированными контролируемыми клиническими исследованиями.

 

The flexible dosage form combined with the increased maintenance of a therapeutic dextensoprazole concentration in plasma with a modified release and prolonged inhibition of acid secretion after administration of the drug suggests that dexlansoprozole has several advantages for patients with acid-dependent diseases. The pharmacokinetic profile of dexlansoprazole is characterized by two Tmax peaks in 1–2 and 4–5 hours after administrating the drug and ensures a stable concentration of it in the blood. The efficacy of dexlansoprozole in the treatment of various forms of gastroesophageal reflux disease has been confirmed by several randomized controlled clinical trials.

гастроэзофагеальная рефлюксная болезньингибиторы протонной помпыприверженность пациентов терапиидекслансопразолgastroesophageal reflux diseaseproton pump inhibitorspatient adherence to therapydexlansoprozoleReferencesЕвсютина Ю.В. Эффективность эзомепразола при лечении пациентов с гастроэзофагеальной рефлюксной болезнью. Российский журнал гастроэнтерол., гепатол., колопроктол., 2017, 27(1): 44-49.Evsyutina YuV. The efficacy of esomeprazole in the treatment of patients with gastroesophageal reflux disease. Rossiyskiy Zhurnal Gastroenterol., Gepatol., Koloproktol., 2017, 27 (1): 44-49.Кардашева С.С., Шульпекова Ю.О., Лещенко В.И. Гастроэзофагеальный рефлюкс: новые перспективы лечения. Медицинский совет, 2017, 11: 92-99.Kardasheva SS, Shulpecova YuO, Leshchenko VI, et al. Gastroesophageal reflux: new treatment prospects. Meditsinsky Sovet, 2017, 11: 92-99.Кучерявый Ю.А., Андреев Д.Н. Перспективы лечения кислотозависимых заболеваний. Клинические перспективы гастроэнтерол., гепатол., 2014, 2: 15-24.Kucheryavy YuA, Andreev DN Prospects for treatment of acid-dependent diseases. Klinicheskie Perspektivy Gastroenterol., Gepatol. 2014, 2: 15-24.Маев И.В., Самсонов А.А., Андреев Д.Н. Перспективы применения ингибитора протонной помпы нового поколения декслансопразола в терапии гастроэзофагеальной рефлюксной болезни. Фарматека, 2015, 2(295): 8-13.Maev IV, Samsonov AA, Andreev DN. Prospects for the use of the new-generation proton pump inhibitor dexlansoprazole in the therapy of gastroesophageal reflux disease. Farmateka, 2015, 2 (295): 8-13.Масловский Л.В., Минушкин О.Н. Терапевтические аспекты гастроэзофагеальной рефлюксной болезни. Эффективная фармакотерапия в гастроэнтерологии, 2008, 1: 2-7.Maslovsky LV, Minushkin ON. Therapeutic aspects of gastroesophageal reflux disease. Effektivnaya Farmakoterapiya v Gastroenterologii, 2008, 1: 2-7.Самсонов А. А., Андреев Д.Н., Юренев Г.Л., Лежнева Ю. А. Современные ингибиторы протонной помпы в терапии гастроэзофагеаль-ной рефлюксной болезни. Врач, 2014, 5: 24-28.Samsonov AA, Andreev DN, Yurenev GL, Lezhneva YuA. Modern proton pump inhibitors in the therapy of gastroesophageal reflux disease. Vrach, 2014, 5: 24-28.Стремоухов А.А. Семиотика болезней пищевода. Наука, 2006. 139 с.Stremoukhov AA. Semiotics of esophagus diseases. Science, 2006. 139 p.Andersson T, Weidolf L. Stereoselective disposition of proton pump inhibitors. Clin Drug Investig, 2008, 28(5): 263-79.Andersson T, Weidolf L. Stereoselective disposition of proton pump inhibitors. Clin Drug Investig, 2008, 28(5): 263-79.Boulanger L, Mody R, Bao Y et al.Does the Dosing Frequency of Proton Pump Inhibitors (PPIs) affect medication adherence among patients diagnosed with gastroesophageal reflux disease (GERD)? Gastroenterology, 2008, 134(4 Suppl.1): A-321-2.Boulanger L, Mody R, Bao Y et al.Does the Dosing Frequency of Proton Pump Inhibitors (PPIs) affect medication adherence among patients diagnosed with gastroesophageal reflux disease (GERD)? Gastroenterology, 2008, 134(4 Suppl.1): A-321-2.Chey WD, Mody RR, Izat E. Patient and physician satisfaction with proton pump inhibitors (PPIs): are there opportunities for improvement? Dig Dis Sci, 2010, 55: 3415–3422.Chey WD, Mody RR, Izat E. Patient and physician satisfaction with proton pump inhibitors (PPIs): are there opportunities for improvement? Dig Dis Sci, 2010, 55: 3415–3422.Chiba N, Gara CJ, Wilkinson JM, Hunt RH. Speed of healing and symptom relief in grade II to IV gastroesophageal reflux disease: A meta-analysis. Gastroenterology, 1997, 112: 1798-1810.Chiba N, Gara CJ, Wilkinson JM, Hunt RH. Speed of healing and symptom relief in grade II to IV gastroesophageal reflux disease: A meta-analysis. Gastroenterology, 1997, 112: 1798-1810.Chao-Hung K, Chien-Yu Lu, Hsiang-Yao Shih et al. CYP2C19 polimorphism influences Helicobacter pilori eradication. World J Gastroenterol, 2014, 20(43): 16029-16036.Chao-Hung K, Chien-Yu Lu, Hsiang-Yao Shih et al. CYP2C19 polimorphism influences Helicobacter pilori eradication. World J Gastroenterol, 2014, 20(43): 16029-16036.Dulta U, Armstrong D. Novel pharmaceutical approaches to refluxe disease. Gastroenterol Clin North America, 2013, 42(1):93-117.Dulta U, Armstrong D. Novel pharmaceutical approaches to refluxe disease. Gastroenterol Clin North America, 2013, 42(1):93-117.Fass R, Chey WD, Zakko SF et al. Clinical trial: the effects of the proton pump inhibitor dexlansoprazole MRon daytime and nighttime heartburn in patients with non-erosive reflux disease. Aliment Pharmacol Ther, 2009, 29(12): 1261–1272.Fass R, Chey WD, Zakko SF et al. Clinical trial: the effects of the proton pump inhibitor dexlansoprazole MRon daytime and nighttime heartburn in patients with non-erosive reflux disease. Aliment Pharmacol Ther, 2009, 29(12): 1261–1272.Fass R, Johnson DA, Orr WC et al. The effect of dexlansoprazole MR on noctumal heartbum and GERD-related sleep disturbances in patients and symptomatic GERD. Amer J Gastroenterol, 2011, 106(3): 421-431.Fass R, Johnson DA, Orr WC et al. The effect of dexlansoprazole MR on noctumal heartbum and GERD-related sleep disturbances in patients and symptomatic GERD. Amer J Gastroenterol, 2011, 106(3): 421-431.Fass R, Inadomi J, Han C et al. Maintenance of heartburn relief after step-down from twice-daily proton pump inhibitor to once-daily dexlansoprazole modified release. Clin Gastroenterol Hepatol, 2012, 10(3): 247–263.Fass R, Inadomi J, Han C et al. Maintenance of heartburn relief after step-down from twice-daily proton pump inhibitor to once-daily dexlansoprazole modified release. Clin Gastroenterol Hepatol, 2012, 10(3): 247–263.Frelinger AL, Lee RD, Mulford DJ et al. A rand-omized, 2-period, cross-over design study to assess the effects of dexlansoprazole, lansoprazole, esomeprazole and omeprazole on the steady-state pharmacokinetics and pharmaco-dynamics of clopidogrel in healthy volunteers. J Amer Coll Cardiol, 2012,5 9(14): 1304-1411.Frelinger AL, Lee RD, Mulford DJ et al. A rand-omized, 2-period, cross-over design study to assess the effects of dexlansoprazole, lansoprazole, esomeprazole and omeprazole on the steady-state pharmacokinetics and pharmaco-dynamics of clopidogrel in healthy volunteers. J Amer Coll Cardiol, 2012,5 9(14): 1304-1411.Haastrup PF, Paulsen MS, Christensen RD, Sonder gaard J, Hansen JM, Jarbol DE. Medical and non-medical predictors of initiating longterm use of proton pump inhibitors: a nationwide cohort study of first-time users during a 10-year period. Aliment Pharmacol Ther, 2016, 44(1): 78-87.Haastrup PF, Paulsen MS, Christensen RD, Sonder gaard J, Hansen JM, Jarbol DE. Medical and non-medical predictors of initiating longterm use of proton pump inhibitors: a nationwide cohort study of first-time users during a 10-year period. Aliment Pharmacol Ther, 2016, 44(1): 78-87.Jaspersen D, Kulig M, Labenz J et al. Prevalence of extra-oesophageal manifestations in gastrooesophageal reflux disease: an analysis based on the ProGERD Study. Aliment Pharmacol Ther, 2003, 17(12): 1515–1520.Jaspersen D, Kulig M, Labenz J et al. Prevalence of extra-oesophageal manifestations in gastrooesophageal reflux disease: an analysis based on the ProGERD Study. Aliment Pharmacol Ther, 2003, 17(12): 1515–1520.Krznaric Z, Ljubas Keletic D, Rustemovic N еt al. Pharmaceutical principles of acid inhibitors: unmet needs. Dis Dis, 2011, 29(5): 469-475.Krznaric Z, Ljubas Keletic D, Rustemovic N еt al. Pharmaceutical principles of acid inhibitors: unmet needs. Dis Dis, 2011, 29(5): 469-475.Kukulka M, Corey Eisenberg C, Nudurupati S. Comparator pH Studu to evaluate the single-dose pharmacodynamics of dual delayed-release dexlansoprazole 60 mg and delayed-release esomeprazole 40 mg. Clin Exp Gastroenterol, 2011, 4: 213-220.Kukulka M, Corey Eisenberg C, Nudurupati S. Comparator pH Studu to evaluate the single-dose pharmacodynamics of dual delayed-release dexlansoprazole 60 mg and delayed-release esomeprazole 40 mg. Clin Exp Gastroenterol, 2011, 4: 213-220.Lee RD, Vakily M, Mulford D, Wu J, Atkinson SN. Clinical trial: the effect and timing of food on the pharmacokinetics and pharmacodynamics of dexlansoprazole MR, a novel dual delayed release formulation of a proton pump inhibitor – evidence for dosing flexibility. Aliment Pharmacol Ther, 2009, 29(8): 824–833.Lee RD, Vakily M, Mulford D, Wu J, Atkinson SN. Clinical trial: the effect and timing of food on the pharmacokinetics and pharmacodynamics of dexlansoprazole MR, a novel dual delayed release formulation of a proton pump inhibitor – evidence for dosing flexibility. Aliment Pharmacol Ther, 2009, 29(8): 824–833.Lee RD, Mulford D, Wu J, Atkinson SN. The effect of time-of-day dosing on the pharmacokinetics and pharmacodynamics of dexlansoprazole MR evidence for dosing flexibility with a Dual Delayed Reltase proton pump inhibitor. Aliment Pharmacol Ther, 2010, 31(9): 1001–1011.Lee RD, Mulford D, Wu J, Atkinson SN. The effect of time-of-day dosing on the pharmacokinetics and pharmacodynamics of dexlansoprazole MR evidence for dosing flexibility with a Dual Delayed Reltase proton pump inhibitor. Aliment Pharmacol Ther, 2010, 31(9): 1001–1011.Mayer MD, Vakily M, Witt G, Mulford DJ. The Pharmacokinetics of TAK-39OMR 60 mg,a dual delayed release formulation of the proton pump inhibitor TAK-390, and lansoprazole 60 mg: a retrospective analysis. Gastroenterology, 2008, 134(Suppl.1): A-176.Mayer MD, Vakily M, Witt G, Mulford DJ. The Pharmacokinetics of TAK-39OMR 60 mg,a dual delayed release formulation of the proton pump inhibitor TAK-390, and lansoprazole 60 mg: a retrospective analysis. Gastroenterology, 2008, 134(Suppl.1): A-176.Metz DC, Howden CW, Perez MC et al. Clinical trial dexlansoprazole MR a proton pump inhibitor with dual delayed – release technology, effectively controls symptoms and prevents relapse in patients with healed erosive oesophagitis. Aliment Pharmacol Ther, 2009, 29(7): 742-754.Metz DC, Howden CW, Perez MC et al. Clinical trial dexlansoprazole MR a proton pump inhibitor with dual delayed – release technology, effectively controls symptoms and prevents relapse in patients with healed erosive oesophagitis. Aliment Pharmacol Ther, 2009, 29(7): 742-754.Metz DC, Vakily M, Dixit T, Mulford D. Review article dual delayed release formulation of dexlansoprazole MR, a novel approach to overcome the limitatation of conventional single release proton pump inhibitor therapy. Aliment Pharmacol Ther, 2009, 29(9): 928-937.Metz DC, Vakily M, Dixit T, Mulford D. Review article dual delayed release formulation of dexlansoprazole MR, a novel approach to overcome the limitatation of conventional single release proton pump inhibitor therapy. Aliment Pharmacol Ther, 2009, 29(9): 928-937.Mermelstein J, Mermelstein АС, Chait ММ. Proton pump inhibitors for the treatment of patients with erosive esophagitis and gastroesophageal reflux disease: current evidence and safety of dexlansoprazole. Clin Exp Gastroenterol, 2016, 9: 163-172.Mermelstein J, Mermelstein АС, Chait ММ. Proton pump inhibitors for the treatment of patients with erosive esophagitis and gastroesophageal reflux disease: current evidence and safety of dexlansoprazole. Clin Exp Gastroenterol, 2016, 9: 163-172.Peura DA, Pilmer B, Hunt B, Mody R, Perez MC. The effects of increasing body mass index on heartburn severity, frequency and response to treatment with dexlansoprazole or lansoprazole. Aliment Pharmacol Ther, 2013, 37(8): 810–818.Peura DA, Pilmer B, Hunt B, Mody R, Perez MC. The effects of increasing body mass index on heartburn severity, frequency and response to treatment with dexlansoprazole or lansoprazole. Aliment Pharmacol Ther, 2013, 37(8): 810–818.Sharma P, Shaheen NJ, Perez MC, et al. Clinical trials: healing of erosive oesophagitis with dexlansoprazole MR, a proton pump inhibitor with a novel dual delayed-release formulation - results from two randomized controlled studies. Aliment Pharmacol Ther, 2009, 29(7): 731-741.Sharma P, Shaheen NJ, Perez MC, et al. Clinical trials: healing of erosive oesophagitis with dexlansoprazole MR, a proton pump inhibitor with a novel dual delayed-release formulation - results from two randomized controlled studies. Aliment Pharmacol Ther, 2009, 29(7): 731-741.Solem C, Mody R, Stephens J et al. Mealtime-related dosing directions for proton-pump inhibitors in gastroesophageal reflux disease: Physician knowledge, patient adherence. J Am Pharm Ass, 2014, 54(2): 144-153.Solem C, Mody R, Stephens J et al. Mealtime-related dosing directions for proton-pump inhibitors in gastroesophageal reflux disease: Physician knowledge, patient adherence. J Am Pharm Ass, 2014, 54(2): 144-153.Vakil N, van Zanten SV, Kahnlas P et al. Global Consensus Group. The Montreal definition and classification of gastroesophageal reflux disease a global evidence-based consensus. Amer J Gastroenterol, 2006, 101: 900-920.Vakil N, van Zanten SV, Kahnlas P et al. Global Consensus Group. The Montreal definition and classification of gastroesophageal reflux disease a global evidence-based consensus. Amer J Gastroenterol, 2006, 101: 900-920.Vakily M, Zhang W, Wu J еt al. Pharmacokinetics and pharmacodynamics of a known active PPI with a novel Dual Delaed Release thechnology, dexlansoprazole MR: a combined analysis of randomized controlled clinical trials. Curr Res Opin, 2009, 25: 527-538.Vakily M, Zhang W, Wu J еt al. Pharmacokinetics and pharmacodynamics of a known active PPI with a novel Dual Delaed Release thechnology, dexlansoprazole MR: a combined analysis of randomized controlled clinical trials. Curr Res Opin, 2009, 25: 527-538.Wahlqvist P, Carlsson J, Stаlhammar NO, Wiklund I. Validity of a Work Productivity and Activity Impairment questionnaire for patients with symptoms of gastro-esophageal reflux disease (WPAI-GERD)–results from a cross-sectional study. Value Health, 2002, 5(2): 102-113.Wahlqvist P, Carlsson J, Stаlhammar NO, Wiklund I. Validity of a Work Productivity and Activity Impairment questionnaire for patients with symptoms of gastro-esophageal reflux disease (WPAI-GERD)–results from a cross-sectional study. Value Health, 2002, 5(2): 102-113.Farup C, Kleinman L, Sloan S et al. The impact of nocturnal symptoms associated with gastroesophageal reflux disease on health-related quality of life. Arch Intern Med, 2001, 161: 45-52.Farup C, Kleinman L, Sloan S et al. The impact of nocturnal symptoms associated with gastroesophageal reflux disease on health-related quality of life. Arch Intern Med, 2001, 161: 45-52.Dean BB, Aguilar D, Johnson LF et al. The relationship between the prevalence of nighttime gastroesophageal reflux disease and disease severity. Dig Dis Sci, 2009, 55: 952–9.Dean BB, Aguilar D, Johnson LF et al. The relationship between the prevalence of nighttime gastroesophageal reflux disease and disease severity. Dig Dis Sci, 2009, 55: 952–9.Mody R, Bolge SC, Kannan H et al. Effects of gas-troesophageal reflux disease on sleep and outcomes. Clin Gastroenterol Hepatol, 2009, 7: 953-9.Mody R, Bolge SC, Kannan H et al. Effects of gas-troesophageal reflux disease on sleep and outcomes. Clin Gastroenterol Hepatol, 2009, 7: 953-9.Shaker R, Castell DO, Schoenfeld PS et al. Nighttime heartburn is an under-appreciated clinical problem that impacts sleep and daytime function: the results of a Gallup survey conducted on behalf of the American Gastroenterological Association. Am J Gastroenterol, 2003, 98: 1487-93.Shaker R, Castell DO, Schoenfeld PS et al. Nighttime heartburn is an under-appreciated clinical problem that impacts sleep and daytime function: the results of a Gallup survey conducted on behalf of the American Gastroenterological Association. Am J Gastroenterol, 2003, 98: 1487-93.Calleja JL, Bixquert M, Maldonado J. Impact of nocturnal heartburn on quality of life, sleep, and productivity: the SINERGE study. Dig Dis Sci, 2007, 52: 2858-65.Calleja JL, Bixquert M, Maldonado J. Impact of nocturnal heartburn on quality of life, sleep, and productivity: the SINERGE study. Dig Dis Sci, 2007, 52: 2858-65.Dubois RW, Aguilar D, Fass R et al. Consequences of frequent nocturnal gastrooesophageal reflux disease among employed adults: symptom severity, quality of life and work productivity. Aliment Pharmacol Ther, 2007, 25: 487-500.Dubois RW, Aguilar D, Fass R et al. Consequences of frequent nocturnal gastrooesophageal reflux disease among employed adults: symptom severity, quality of life and work productivity. Aliment Pharmacol Ther, 2007, 25: 487-500.Dean BB, Crawley JA, Schmitt CM et al. The burden of illness of gastrooesophageal reflux disease: impact on work productivity. Aliment Pharmacol Ther, 2003, 17: 1309–17.Dean BB, Crawley JA, Schmitt CM et al. The burden of illness of gastrooesophageal reflux disease: impact on work productivity. Aliment Pharmacol Ther, 2003, 17: 1309–17.Manocchia M, Keller S, Ware JE. Sleep problems, health-related quality of life, work functioning and health care utilization among the chronically ill. Qual Life Res, 2001, 10: 331–45.Manocchia M, Keller S, Ware JE. Sleep problems, health-related quality of life, work functioning and health care utilization among the chronically ill. Qual Life Res, 2001, 10: 331–45.Peghini PL, Katz PO, Bracy NA, Castell DO. Nocturnal recovery of gastric acid secretion with twice-daily dosing of proton pump inhibitors. Am J Gastroenterol, 1998, 93(5): 763-767.Peghini PL, Katz PO, Bracy NA, Castell DO. Nocturnal recovery of gastric acid secretion with twice-daily dosing of proton pump inhibitors. Am J Gastroenterol, 1998, 93(5): 763-767.Dent J, Tytgat G. Reflux disease management strategy: initial therapy. Aliment Pharmacol Ther,. 2003, 17(Suppl. 1): 28-52.Dent J, Tytgat G. Reflux disease management strategy: initial therapy. Aliment Pharmacol Ther,. 2003, 17(Suppl. 1): 28-52.Castiglione F, Emde С, Armstrong D, Schneider C, Bauerfeind P, Stacker G, Blum AL. Nocturnal oesophageal motor activity is dependent on sleep stage. Gut, 1993, 34(12): 1653-1659.Castiglione F, Emde С, Armstrong D, Schneider C, Bauerfeind P, Stacker G, Blum AL. Nocturnal oesophageal motor activity is dependent on sleep stage. Gut, 1993, 34(12): 1653-1659.Or WC, Goodrich S, Fernstrom P, Hasselgren G. Occurrence of nighttime gastroesophageal reflux in disturbed and normal sleepers. Clin Gastroenterol Hepatol, 2008, 6(10): 1099-1104.Or WC, Goodrich S, Fernstrom P, Hasselgren G. Occurrence of nighttime gastroesophageal reflux in disturbed and normal sleepers. Clin Gastroenterol Hepatol, 2008, 6(10): 1099-1104.Freidin N, Fisher MJ, Taylor W, Boyd D, Surratt P, McCallum RW, Mittal RK. Sleep and nocturnal acid reflux in normal subjects and patients with reflux oesophagitis. Gut, 1991, 32(11): 1275-1279.Freidin N, Fisher MJ, Taylor W, Boyd D, Surratt P, McCallum RW, Mittal RK. Sleep and nocturnal acid reflux in normal subjects and patients with reflux oesophagitis. Gut, 1991, 32(11): 1275-1279.

The authors declare that there are no conflicts of interest present.