Abstract
The preventive effects of lansoprazole and famotidine on low-dose aspirin-induced gastric mucosal injury in relation to gastric acidity were compared in healthy Japanese volunteers. Fifteen Helicobacter pylori-negative volunteers with different CYP2C19 genotypes were randomly administered aspirin 100 mg, aspirin plus famotidine 20 mg twice daily, or aspirin plus lansoprazole 15 mg once daily for 7 days each in a crossover fashion. Gastroscopy for the evaluation of mucosal injury based on modified Lanza score (MLS) and 24-hour intragastric pH monitoring were performed on day 7 of each regimen. Aspirin induced gastric mucosal injury (median MLS = 3). Lansoprazole significantly decreased MLS to 0, which was significantly lower than that by famotidine (MLS = 1) (P < .05). Medians of pH 3 holding time and mean 24-hour pH values with the lansoprazole regimen were significantly higher than those with famotidine (P < .05). No significant differences in MLS were observed among the different CYP2C19 genotype groups in any of the treatment regimens. In this 7-day study, lansoprazole appeared to be more protective than famotidine against low-dose aspirin-induced mucosal injury but a larger well-controlled study is necessary to establish a definitive clinical benefit.
Publication types
-
Clinical Trial
-
Comparative Study
-
Randomized Controlled Trial
-
Research Support, Non-U.S. Gov't
MeSH terms
-
2-Pyridinylmethylsulfinylbenzimidazoles / administration & dosage
-
2-Pyridinylmethylsulfinylbenzimidazoles / therapeutic use*
-
Adult
-
Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
-
Anti-Inflammatory Agents, Non-Steroidal / toxicity
-
Anti-Ulcer Agents / administration & dosage
-
Anti-Ulcer Agents / therapeutic use*
-
Aryl Hydrocarbon Hydroxylases / genetics
-
Aspirin / administration & dosage
-
Aspirin / toxicity
-
Cross-Over Studies
-
Cytochrome P-450 CYP2C19
-
Famotidine / administration & dosage
-
Famotidine / therapeutic use*
-
Female
-
Gastric Acidity Determination
-
Gastric Mucosa / drug effects*
-
Gastric Mucosa / pathology
-
Genotype
-
Histamine H2 Antagonists / administration & dosage
-
Histamine H2 Antagonists / therapeutic use*
-
Humans
-
Japan
-
Lansoprazole
-
Male
-
Proton Pump Inhibitors*
-
Severity of Illness Index
-
Stomach Ulcer / chemically induced
-
Stomach Ulcer / genetics
-
Stomach Ulcer / pathology
-
Stomach Ulcer / prevention & control*
-
Young Adult
Substances
-
2-Pyridinylmethylsulfinylbenzimidazoles
-
Anti-Inflammatory Agents, Non-Steroidal
-
Anti-Ulcer Agents
-
Histamine H2 Antagonists
-
Proton Pump Inhibitors
-
Lansoprazole
-
Famotidine
-
Aryl Hydrocarbon Hydroxylases
-
CYP2C19 protein, human
-
Cytochrome P-450 CYP2C19
-
Aspirin