Dyspepsia Clinical Trial
Official title:
With-Drawal Study of Proton-Pump-Inhibitors in Patients From Primary Care Who Have Previously Been Treated on a Long-Term Basis
The primary purpose of the study is to determine the effect of esomeprazole compared to placebo in patients from general practice who have previously been treated with proton-pump-inhibitors (PPI) and who have no upper endoscopic findings.
The majority of patients with dyspepsia are treated in primary care with acid-suppressive
therapy for shorter or longer periods of time on the assumption that the patients´ symptoms
are related to the production of acid in the stomach.
In about half of the dyspeptic patients there is no structural or biochemical explanation
for their symptoms. These patients suffer from functional dyspepsia.
Treatment with proton-pump-inhibitors is effective in treating patients with
gastroesophageal refluxdisease or ulcers. It is however controversial if acid-suppressive
treatment is effective in the large group of patients with functional dyspepsia. Previous
studies have shown no or very modest effect with a very high placeboresponse rate of 40-50%.
In primary care patients with upper abdominal symptoms are often treated with PPI as a
diagnostic tool. If the treatment is effective continued or repeated treatment with PPI is
often favored. However some of the patients must experience the abovementioned
placebo-effect. These patients may end up being treated with PPI long-term on uncertain
indication.
We wish to investigate the consequences of withdrawing treatment with PPI in patients from
general practice who have previously been treated long-term.
An upper endoscopy is performed in patients who experience upper abdominal symptoms after
withdrawal of treatment.If the endoscopy is normal patients are randomised to 1 week
treatment with either esomeprazole or placebo.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double-Blind, Primary Purpose: Treatment
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