From a purely economic perspective, the ideal medication for a drug company’s bottom line is one that the patient needs to take daily for the rest of his or her life.
Nexium seems to fill the bill. Moreover, it appears to make the problem it seeks to treat (acid reflux) worse. If the patient doesn’t actually need the drug but is prescribed it nonetheless, changes frequently occur that make it extremely difficult to withdraw from the drug. This is called “rebound acid reflux.”
Proton-pump inhibitors may cause or aggravate the very acid-reflux symptoms they’re used to treat, according to a randomized trial.
After a two-month course of esomeprazole (Nexium), 44% of asymptomatic, healthy volunteers had clinically significant heartburn, acid reflux, or dyspepsia, compared with 15% who had taken placebo (P<0.001), according to researchers led by Peter Bytzer, MD, PhD, of Copenhagen University and Køge University Hospital.
This apparent rebound acid secretion, to a point above baseline levels, could lead to PPI dependence, the group reported in the July issue of Gastroenterology.
Treatment guidelines support the typical primary care practice of initiating a trial of PPI treatment empirically for dyspeptic symptoms, the researchers said.
