2024
Impact of large scale, multicomponent intervention to reduce proton pump inhibitor overuse in integrated healthcare system: difference-in-difference study
Kurlander J, Laine L, Kim H, Roberts C, Saffar D, Myers A, Holleman R, Gao Y, Shank M, Nelson R, Forman J, Helfrich C, Krein S, Saini S, Yang Y. Impact of large scale, multicomponent intervention to reduce proton pump inhibitor overuse in integrated healthcare system: difference-in-difference study. The BMJ 2024, 385: e076484. PMID: 38604668, PMCID: PMC11007585, DOI: 10.1136/bmj-2023-076484.Peer-Reviewed Original ResearchMeSH KeywordsAgedDelivery of Health Care, IntegratedGastrointestinal DiseasesGastrointestinal HemorrhageHistamine H2 AntagonistsHumansProton Pump InhibitorsConceptsPrimary care visitsProton pump inhibitors prescriptionUpper gastrointestinal diagnosesMulticomponent interventionCare visitsHealthcare systemHospital admissionUS Veterans Affairs Healthcare SystemVeterans Affairs Healthcare SystemAbsolute reductionGastrointestinal diagnosesIntegrated healthcare systemProton pump inhibitor overuseReducing proton-pump inhibitorDifference-in-differences studyProton pump inhibitorsPercentage of patientsProton pump inhibitor useAcid peptic diseaseElectronic prescribingPrimary careHealthcare utilizationIntervention sitesPPI prescriptionsOlder adults
2022
Vonoprazan Versus Lansoprazole for Healing and Maintenance of Healing of Erosive Esophagitis: A Randomized Trial
Laine L, DeVault K, Katz P, Mitev S, Lowe J, Hunt B, Spechler S. Vonoprazan Versus Lansoprazole for Healing and Maintenance of Healing of Erosive Esophagitis: A Randomized Trial. Gastroenterology 2022, 164: 61-71. PMID: 36228734, DOI: 10.1053/j.gastro.2022.09.041.Peer-Reviewed Original ResearchMeSH KeywordsAdultEsophagitisHumansLansoprazolePeptic UlcerProton Pump InhibitorsPyrrolesSulfonamidesTreatment OutcomeConceptsMaintenance of healingProton pump inhibitorsErosive esophagitisSecondary analysisD esophagitisPrimary analysisEnd pointPotassium-competitive acid blocker vonoprazanHeartburn-free daysSevere erosive esophagitisMainstay of treatmentPrimary end pointSecondary end pointsPotent acid inhibitionPPI lansoprazolePump inhibitorsEsophagitisNoninferiority comparisonVonoprazanWeek 2Healing phaseAbstractTextPatientsLansoprazoleSuperiority analysisAssociation of Antisecretory Drugs with Upper Gastrointestinal Bleeding in Patients Using Oral Anticoagulants: A Systematic Review and Meta-Analysis
Kurlander JE, Barnes GD, Fisher A, Gonzalez JJ, Helminski D, Saini SD, Sengupta N, Yang YX, Scheiman J, Laine L. Association of Antisecretory Drugs with Upper Gastrointestinal Bleeding in Patients Using Oral Anticoagulants: A Systematic Review and Meta-Analysis. The American Journal Of Medicine 2022, 135: 1231-1243.e8. PMID: 35679879, PMCID: PMC10031639, DOI: 10.1016/j.amjmed.2022.05.031.Peer-Reviewed Original ResearchConceptsUpper gastrointestinal bleedingProton pump inhibitorsGastrointestinal bleedingH2-receptor antagonistsObservational studyOral anticoagulantsAntisecretory drugsRelative riskLower riskNonsteroidal anti-inflammatory drug useSystematic reviewAnti-inflammatory drug useOvert upper gastrointestinal bleedingLow statistical heterogeneitySingle observational studyGreater treatment effectRandom-effects modelWeb of ScienceConcomitant aspirinRandomized trialsCochrane LibraryPump inhibitorsBias assessmentStatistical heterogeneityBleedingVonoprazan Triple and Dual Therapy for Helicobacter pylori Infection in the United States and Europe: Randomized Clinical Trial
Chey WD, Mégraud F, Laine L, López LJ, Hunt BJ, Howden CW. Vonoprazan Triple and Dual Therapy for Helicobacter pylori Infection in the United States and Europe: Randomized Clinical Trial. Gastroenterology 2022, 163: 608-619. PMID: 35679950, DOI: 10.1053/j.gastro.2022.05.055.Peer-Reviewed Original ResearchConceptsEradication rateHelicobacter pylori infectionTriple therapyDual therapyPylori infectionProton pump inhibitor-based triple therapyTreatment-emergent adverse eventsInhibitor-based triple therapyPotassium-competitive acid blockerEfficacy of vonoprazanH pylori eradicationPhase 3 trialOverall study populationAmoxicillin-resistant strainsClarithromycin-resistant strainsH pylori infectionTreatment-naïve adultsPylori eradicationAdverse eventsSecondary outcomesPrimary outcomeStandard treatmentClinical trialsStudy populationAcid blockerPharmacodynamics and Pharmacokinetics of the Potassium-Competitive Acid Blocker Vonoprazan and the Proton Pump Inhibitor Lansoprazole in US Subjects
Laine L, Sharma P, Mulford DJ, Hunt B, Leifke E, Smith N, Howden CW. Pharmacodynamics and Pharmacokinetics of the Potassium-Competitive Acid Blocker Vonoprazan and the Proton Pump Inhibitor Lansoprazole in US Subjects. The American Journal Of Gastroenterology 2022, 117: 1158-1161. PMID: 35294415, DOI: 10.14309/ajg.0000000000001735.Peer-Reviewed Original ResearchMeSH KeywordsAdultHumansHydrogen-Ion ConcentrationLansoprazolePotassiumProton Pump InhibitorsPyrrolesSulfonamides
2021
ACG Clinical Guideline: Upper Gastrointestinal and Ulcer Bleeding
Laine L, Barkun AN, Saltzman JR, Martel M, Leontiadis GI. ACG Clinical Guideline: Upper Gastrointestinal and Ulcer Bleeding. The American Journal Of Gastroenterology 2021, 116: 899-917. PMID: 33929377, DOI: 10.14309/ajg.0000000000001245.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsUpper gastrointestinal bleedingEndoscopic therapyGastrointestinal bleedingHigh-dose proton pump inhibitor therapyOvert upper gastrointestinal bleedingOral proton pump inhibitorsProton pump inhibitor therapyRed blood cell transfusionAbsolute ethanol injectionWeeks of therapyBlood cell transfusionLow-quality evidenceLow-risk patientsManagement of patientsProton pump inhibitorsArgon plasma coagulationActive spurtingErythromycin infusionTC-325Cell transfusionRecurrent bleedingRecurrent ulcersUlcer bleedingEndoscopic hemostasisGRADE approach
2020
Use of Proton Pump Inhibitors Increases Risk of Incident Kidney Stones
Simonov M, Abel EA, Skanderson M, Masoud A, Hauser RG, Brandt CA, Wilson FP, Laine L. Use of Proton Pump Inhibitors Increases Risk of Incident Kidney Stones. Clinical Gastroenterology And Hepatology 2020, 19: 72-79.e21. PMID: 32147588, PMCID: PMC7483196, DOI: 10.1016/j.cgh.2020.02.053.Peer-Reviewed Original ResearchMeSH KeywordsCohort StudiesFemaleHumansKidney CalculiMaleProton Pump InhibitorsRetrospective StudiesRisk FactorsConceptsProton pump inhibitorsPPI useKidney stonesCohort studyLevothyroxine useTime-varying Cox proportional hazardsHistamine-2 receptor antagonistsPropensity score-matched subsetIncident kidney stonesUrinary ion concentrationsLarge cohort studyCox proportional hazardsPropensity matching analysisDose-dependent increaseNegative control exposureH2RA usePPI usersMost patientsPPI usageAcid suppressionAdjusted analysisMedication usageRetrospective studyPump inhibitorsUnadjusted analysesPhysicians' Perceptions of Proton Pump Inhibitor Risks and Recommendations to Discontinue: A National Survey.
Kurlander JE, Rubenstein JH, Richardson CR, Krein SL, De Vries R, Zikmund-Fisher BJ, Yang YX, Laine L, Weissman A, Saini SD. Physicians' Perceptions of Proton Pump Inhibitor Risks and Recommendations to Discontinue: A National Survey. The American Journal Of Gastroenterology 2020, 115: 689-696. PMID: 32091419, PMCID: PMC7196016, DOI: 10.14309/ajg.0000000000000558.Peer-Reviewed Original ResearchConceptsProton pump inhibitorsPPI adverse effectsAdverse effectsHigh riskLong-term PPI useGastroesophageal reflux diseaseMultiple adverse effectsPPI useReflux diseasePPI discontinuationInhibitor riskMost internistsPump inhibitorsPhysicians' perceptionsInternists' perceptionsSignificant associationGeneral medicineDiscontinuationLogistic regressionClinical usePatientsFuture interventionsIndividual riskPreventionUGIB
2019
Management of Nonvariceal Upper Gastrointestinal Bleeding: Guideline Recommendations From the International Consensus Group.
Barkun AN, Almadi M, Kuipers EJ, Laine L, Sung J, Tse F, Leontiadis GI, Abraham NS, Calvet X, Chan FKL, Douketis J, Enns R, Gralnek IM, Jairath V, Jensen D, Lau J, Lip GYH, Loffroy R, Maluf-Filho F, Meltzer AC, Reddy N, Saltzman JR, Marshall JK, Bardou M. Management of Nonvariceal Upper Gastrointestinal Bleeding: Guideline Recommendations From the International Consensus Group. Annals Of Internal Medicine 2019, 171: 805-822. PMID: 31634917, PMCID: PMC7233308, DOI: 10.7326/m19-1795.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsUpper gastrointestinal bleedingNonvariceal upper gastrointestinal bleedingHigh-risk stigmataPPI therapyGastrointestinal bleedingEndoscopic therapyCardiovascular diseaseHigh-dose proton pump inhibitor therapyEvidence profilesProton pump inhibitor therapyGlasgow-Blatchford scoreOral PPI therapyPrevious ulcer bleedingHigh-risk patientsHours of presentationManagement of patientsSuccessful endoscopic therapyStrength of recommendationsQuality of evidenceInternational consensus recommendationsInternational multidisciplinary groupInternational Consensus GroupElectronic bibliographic databasesTC-325Blatchford scoreRandomized Trial of Medical versus Surgical Treatment for Refractory Heartburn
Spechler SJ, Hunter JG, Jones KM, Lee R, Smith BR, Mashimo H, Sanchez VM, Dunbar KB, Pham TH, Murthy UK, Kim T, Jackson CS, Wallen JM, von Rosenvinge EC, Pearl JP, Laine L, Kim AW, Kaz AM, Tatum RP, Gellad ZF, Lagoo-Deenadayalan S, Rubenstein JH, Ghaferi AA, Lo WK, Fernando RS, Chan BS, Paski SC, Provenzale D, Castell DO, Lieberman D, Souza RF, Chey WD, Warren SR, Davis-Karim A, Melton SD, Genta RM, Serpi T, Biswas K, Huang GD. Randomized Trial of Medical versus Surgical Treatment for Refractory Heartburn. New England Journal Of Medicine 2019, 381: 1513-1523. PMID: 31618539, DOI: 10.1056/nejmoa1811424.Peer-Reviewed Original ResearchConceptsPPI-refractory heartburnActive medical treatmentMedical treatmentTreatment successGastroenterology clinicSurgical treatmentProton pump inhibitor treatmentMultichannel intraluminal impedance-pH monitoringMedical groupGastroesophageal reflux diseaseFrequent clinical problemMinority of patientsHealth Related QualityImpedance-pH monitoringMultiple potential causesFunctional heartburnRefractory heartburnVisceral hypersensitivityAntireflux surgeryGastroesophageal refluxReflux diseaseUnderwent endoscopyEsophageal manometryPrimary outcomeEsophageal biopsiesManagement of acute upper gastrointestinal bleeding
Stanley AJ, Laine L. Management of acute upper gastrointestinal bleeding. The BMJ 2019, 364: l536. PMID: 30910853, DOI: 10.1136/bmj.l536.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsMeSH KeywordsAnti-Bacterial AgentsBlood TransfusionDisease ManagementEndoscopy, GastrointestinalEsophageal and Gastric VaricesGastrointestinal HemorrhageHumansLiver CirrhosisPortasystemic Shunt, Transjugular IntrahepaticPractice Guidelines as TopicProton Pump InhibitorsResuscitationSeverity of Illness IndexConceptsUpper gastrointestinal bleedingProton pump inhibitorsVariceal bleedingUlcer bleedingGastrointestinal bleedingEndoscopic therapyVasoactive drugsPump inhibitorsHigh-dose proton pump inhibitorsAcute upper gastrointestinal bleedingDose proton pump inhibitorsTransjugular intrahepatic portosystemic shuntNon-variceal bleedingRecurrent ulcer bleedingRecurrent variceal bleedingRed cell transfusionCommon medical emergencyIntrahepatic portosystemic shuntEarly endoscopyCell transfusionHemodynamic instabilityHemoglobin thresholdEndoscopic treatmentIntravenous fluidsPortosystemic shunt
2018
Effects of gastroprotectant drugs for the prevention and treatment of peptic ulcer disease and its complications: a meta-analysis of randomised trials
Scally B, Emberson JR, Spata E, Reith C, Davies K, Halls H, Holland L, Wilson K, Bhala N, Hawkey C, Hochberg M, Hunt R, Laine L, Lanas A, Patrono C, Baigent C. Effects of gastroprotectant drugs for the prevention and treatment of peptic ulcer disease and its complications: a meta-analysis of randomised trials. The Lancet Gastroenterology & Hepatology 2018, 3: 231-241. PMID: 29475806, PMCID: PMC5842491, DOI: 10.1016/s2468-1253(18)30037-2.Peer-Reviewed Original ResearchConceptsProton pump inhibitorsUpper gastrointestinal bleedingPeptic ulcer diseaseAcute upper gastrointestinal bleedingGastrointestinal bleedingUlcer diseasePrevention trialsHealing trialsBlood transfusionClinical circumstancesProstaglandin analoguesHistamine-2 receptor antagonistsParticular proton pump inhibitorsNon-steroidal anti-inflammatory drugsEndoscopic ulcer healingDifferent clinical circumstancesUK Medical Research CouncilBritish Heart FoundationDifferent clinical settingsAnti-inflammatory drugsSmall study biasFurther endoscopic interventionMedical Research CouncilLarge protective effectEndoscopic ulcers
2016
Efficacy and Safety of Proton-Pump Inhibitors in High-Risk Cardiovascular Subsets of the COGENT Trial
Vaduganathan M, Cannon CP, Cryer BL, Liu Y, Hsieh WH, Doros G, Cohen M, Lanas A, Schnitzer TJ, Shook TL, Lapuerta P, Goldsmith MA, Laine L, Bhatt DL, Investigators C. Efficacy and Safety of Proton-Pump Inhibitors in High-Risk Cardiovascular Subsets of the COGENT Trial. The American Journal Of Medicine 2016, 129: 1002-1005. PMID: 27143321, DOI: 10.1016/j.amjmed.2016.03.042.Peer-Reviewed Original ResearchConceptsDual antiplatelet therapyProton pump inhibitorsAcute coronary syndromePercutaneous coronary interventionCardiovascular eventsCoronary syndromeCoronary interventionGastrointestinal eventsPercutaneous coronary intervention-treated patientsSafety of PPIsUnadjusted Cox proportional hazards modelCox proportional hazards modelDays of randomizationMajor cardiovascular eventsComposite cardiovascular eventsSubset of patientsSafety of omeprazoleProportional hazards modelGastroprotective strategiesMedian followPPI therapyAntiplatelet therapyFrequent indicationHazards modelPatientsLong-Term PPI Use: Balancing Potential Harms and Documented Benefits
Laine L, Nagar A. Long-Term PPI Use: Balancing Potential Harms and Documented Benefits. The American Journal Of Gastroenterology 2016, 111: 913. PMID: 27113114, DOI: 10.1038/ajg.2016.156.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsProton-Pump Inhibitors Reduce Gastrointestinal Events Regardless of Aspirin Dose in Patients Requiring Dual Antiplatelet Therapy
Vaduganathan M, Bhatt DL, Cryer BL, Liu Y, Hsieh WH, Doros G, Cohen M, Lanas A, Schnitzer TJ, Shook TL, Lapuerta P, Goldsmith MA, Laine L, Cannon CP, Investigators C. Proton-Pump Inhibitors Reduce Gastrointestinal Events Regardless of Aspirin Dose in Patients Requiring Dual Antiplatelet Therapy. Journal Of The American College Of Cardiology 2016, 67: 1661-1671. PMID: 27012778, DOI: 10.1016/j.jacc.2015.12.068.Peer-Reviewed Original ResearchMeSH KeywordsAgedAspirinClopidogrelDose-Response Relationship, DrugDrug Therapy, CombinationDyspepsiaFemaleGastrointestinal HemorrhageHumansIntestinal ObstructionIntestinal PerforationMaleMiddle AgedMyocardial InfarctionMyocardial RevascularizationOmeprazolePainPeptic UlcerPlatelet Aggregation InhibitorsProspective StudiesProton Pump InhibitorsStrokeTiclopidineConceptsDual antiplatelet therapyLow-dose aspirinProton pump inhibitorsMajor adverse cardiac eventsAdverse cardiac eventsPPI therapyAntiplatelet therapyAspirin usersGastrointestinal eventsCardiac eventsGI eventsMeier estimatesArtery diseaseCardiovascular endpointsLow-dose aspirin usersPrimary cardiovascular endpointUpper GI eventsHigh-dose aspirinPeripheral artery diseasePercutaneous coronary interventionCoronary artery diseaseHigh rateAspirin groupBlinded gastroenterologistsAspirin dose
2015
The effects of proton pump inhibition on patient‐reported severity of dyspepsia when receiving dual anti‐platelet therapy with clopidogrel and low‐dose aspirin: analysis from the Clopidogrel and the Optimization of Gastrointestinal Events Trial
Vardi M, Cryer BL, Cohen M, Lanas A, Schnitzer TJ, Lapuerta P, Goldsmith MA, Laine L, Doros G, Liu Y, McIntosh AI, Cannon CP, Bhatt DL. The effects of proton pump inhibition on patient‐reported severity of dyspepsia when receiving dual anti‐platelet therapy with clopidogrel and low‐dose aspirin: analysis from the Clopidogrel and the Optimization of Gastrointestinal Events Trial. Alimentary Pharmacology & Therapeutics 2015, 42: 365-374. PMID: 26032114, PMCID: PMC4494867, DOI: 10.1111/apt.13260.Peer-Reviewed Original ResearchConceptsDual anti-platelet therapyAnti-platelet therapyGastrointestinal Event TrialLow-dose aspirinNonpain symptomsEvents trialPatient-reported outcome dataPercent of patientsPatient-reported symptomsPatient-reported outcomesPatient-reported severityOmeprazole groupProphylactic omeprazoleCardiovascular safetyGastrointestinal bleedingPain intensityClinical eventsOmeprazole useClinical significanceOutcome dataAssessment QuestionnaireClopidogrelDyspepsiaTherapyPatients
2014
Intermittent vs Continuous Proton Pump Inhibitor Therapy for High-Risk Bleeding Ulcers: A Systematic Review and Meta-analysis
Sachar H, Vaidya K, Laine L. Intermittent vs Continuous Proton Pump Inhibitor Therapy for High-Risk Bleeding Ulcers: A Systematic Review and Meta-analysis. JAMA Internal Medicine 2014, 174: 1755-1762. PMID: 25201154, PMCID: PMC4415726, DOI: 10.1001/jamainternmed.2014.4056.Peer-Reviewed Original ResearchConceptsHigh-risk bleeding ulcersProton pump inhibitorsAbsolute risk differencePPI therapyBleeding ulcersContinuous infusionRisk differenceRisk ratioSystematic reviewDuplicate independent data extractionUrgent interventionRed blood cell transfusionGuideline-recommended regimenReduction of ulcerBlood cell transfusionCochrane Central RegisterControlled Trials databasesTrial of patientsData extractionIndependent data extractionIntravenous bolus doseRandom-effects modelFixed-effects modelPPI dosePPI infusion
2013
Gastroprotection in Low-Dose Aspirin Users for Primary and Secondary Prevention of ACS: Results of a Cost-Effectiveness Analysis Including Compliance
de Groot NL, van Haalen HG, Spiegel BM, Laine L, Lanas A, Focks JJ, Siersema PD, van Oijen MG. Gastroprotection in Low-Dose Aspirin Users for Primary and Secondary Prevention of ACS: Results of a Cost-Effectiveness Analysis Including Compliance. Cardiovascular Drugs And Therapy 2013, 27: 341-357. PMID: 23417566, DOI: 10.1007/s10557-013-6448-y.Peer-Reviewed Original ResearchMeSH KeywordsAcute Coronary SyndromeAspirinCost-Benefit AnalysisDrug Therapy, CombinationGastrointestinal HemorrhageHealth Care CostsHumansMaleMiddle AgedModels, TheoreticalPatient CompliancePlatelet Aggregation InhibitorsPrimary PreventionProton Pump InhibitorsQuality-Adjusted Life YearsSecondary PreventionConceptsAcute coronary syndromeProton pump inhibitorsUpper GI bleedingSecondary preventionGI bleedingASA monotherapyPPI complianceElevated riskLow-dose ASA usersLow-dose aspirin usersUpper GI side effectsGI side effectsUpper gastrointestinal complicationsCombination of ASABase-case patientProbabilistic sensitivity analysesCost-effectiveness analysisASA usersGastrointestinal complicationsGastroprotective strategiesAspirin usersCoronary syndromePPI useACS eventCase patients
2012
Management of Patients With Ulcer Bleeding
Laine L, Jensen DM. Management of Patients With Ulcer Bleeding. The American Journal Of Gastroenterology 2012, 107: 345. PMID: 22310222, DOI: 10.1038/ajg.2011.480.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsMeSH KeywordsBlood TransfusionClinical Trials as TopicEndoscopy, GastrointestinalErythromycinEvidence-Based MedicineFluid TherapyGastric LavageHemostasis, EndoscopicHumansMeta-Analysis as TopicPatient SelectionPeptic Ulcer HemorrhagePrognosisProton Pump InhibitorsResuscitationRetreatmentRisk AssessmentSecondary PreventionConceptsNonsteroidal anti-inflammatory drugsAnti-ulcer therapyEndoscopic therapyHemodynamic statusCOX-2-selective nonsteroidal anti-inflammatory drugsNon-bleeding visible vesselOvert upper gastrointestinal bleedingDirect further managementSecond endoscopic treatmentStep-wise managementUpper gastrointestinal bleedingManagement of patientsProton pump inhibitorsAnti-inflammatory drugsIdiopathic ulcersPPI therapyActive bleedingGastrointestinal bleedingRecurrent bleedingUlcer bleedingEndoscopic featuresFirst endoscopyUpper endoscopyAdherent clotEndoscopic treatment
2011
Proton Pump Inhibitor Co-therapy With Clopidogrel: Is There GI Benefit or Cardiovascular Harm?
Laine L. Proton Pump Inhibitor Co-therapy With Clopidogrel: Is There GI Benefit or Cardiovascular Harm? Gastroenterology 2011, 140: 769-772.e2. PMID: 21266209, DOI: 10.1053/j.gastro.2011.01.024.Commentaries, Editorials and Letters