[AF] Estudio comparativo de IBP

[Imanol Monteagudo]

Hola

En el Pais Vasco, Sanidad está intentando atajar el gasto que supone la prescripcion de otros IBP, al establecer en informes del Comite de Evaluacion de Nuevos Medicamentos que las diferencias en efectividad no son significativas, la seguridad es menos conocida (por ser medicamentos mas nuevos) y su precio sensiblemente mas alto (sobre todo por la inexistencia de EFG), frente a Omeprazol.

Por ahora han mandado una circular a prescriptores y farmacias informando, pero de no conseguir que la prescripcion no disminuya, continuaran con ello (se habló de solicitar visado).

Podeis consultar mas en euskadi.net/sanidad

Un saludo

Imanol Monteagudo
Farmaceutico Comunitario
Vitoria
  ----- Original Message ----- 
  From: Jose Ramon Garcia Solans 
  To: AF lista 
  Sent: Wednesday, April 07, 2004 11:10 AM
  Subject: [AF] Estudio comparativo de IBP


  Gracias a Rafa Bravo y la Biblioteca del capitán Morgan, me entero de un metanalisis acerca de la diferencia de efectividad y/o potencia de los inhibidores de la bomba de protones, cuyo sumario adjunto. Traducido al castellano: todos los IBP son iguales (y sin llegar a hablar de genéricos)
  Cordiales salu2:
  Jose Ramon Garcia Solans
  Farmaceutico comunitario. Zaragoza
  976 554 986

  Systematic review: direct comparative trials of the efficacy of proton pump inhibitors in the management of gastro-oesophageal reflux disease and peptic ulcer disease N. VAKIL* & M. B. FENNERTY Departments of Medicine, Sections of Gastroenterology, *University of Wisconsin, Milwaukee, WI, USA and 
Oregon Health and Science University, Portland, OR, USA
  Accepted for publication 31 July 2003
  SUMMARY
  Background: Five proton pump inhibitors are now available for use in North America. Claims of differences in the clinical efficacy of different strengths and/or agents have been made.
  Aim: To identify any consistent evidence of differences in outcomes between agents or doses within this class of drugs.
  Methods: A search of the medical literature was performed in two electronic databases, and randomized controlled trials of higher quality were included in the assessment.
  Results and conclusions: Thirty-two trials met our criteria. No convincing data were found to indicate that low doses of proton pump inhibitors are as effective as standard doses of proton pump inhibitors in the healing of erosive oesophagitis or in the relief of symptoms of gastro-oesophageal reflux disease; however, they may be as effective as maintenance therapy for gastro-oesophageal reflux disease and peptic ulcer disease. Differences were found between the standard doses of proton pump inhibitors with regard to the onset of symptom relief in gastro-oesophageal reflux disease (lansoprazole was faster than omeprazole, and esomeprazole was faster than both lansoprazole and omeprazole) and the healing of oesophagitis (esomeprazole was superior to both omeprazole and lansoprazole). 
  Despite these differences, there are as yet insufficient data to establish the superiority of any one agent over all others across all disease states treated with these agents.




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