Chappell Logan, Brown Stephen A, Wensel Terri M
CVSHealth, Birmingham, Alabama.
Samford University McWhorter School of Pharmacy.
Innov Pharm. 2020 Oct 28;11(4). doi: 10.24926/iip.v11i4.3355. eCollection 2020.
Type 2 diabetes mellitus and gastroesophageal reflux disease are highly prevalent in the United States. First-line therapies for these disease states include metformin and proton pump inhibitors, respectively. Both of these medications have been associated with a decreased absorption of vitamin B12.
The objective of this study was to assess the prevalence of B12 monitoring and supplementation in patients receiving concomitant metformin and PPI therapy.
A retrospective data analysis was performed at a single federally qualified health center. Patients receiving concomitant metformin and PPI therapy (specifically omeprazole and pantoprazole) over the past year were included. Data collected included demographics, dosing, therapy duration, and vitamin B12 level. Data were analyzed using descriptive statistics.
A total of 104 patients met the inclusion criteria for this study. Metformin 1000 mg immediate release tablets was the most common dose and formulation prescribed. Omeprazole and pantoprazole were the most commonly prescribed PPIs. The most frequent duration of therapy was 1 to 4 years. Fourteen patients had a documented B12 level and no patients were categorized as deficient. Seven patients were prescribed a B12 supplement during the study period.
In this single center, retrospective chart review of patients receiving concomitant metformin and PPI therapy, the average duration of therapy for both agents was 1-4 years. Only 13.5% of patients had a documented B12 level. Of those patients, none were categorized as deficient. Though routine monitoring of B12 levels may be important for patients on long-term therapy with both agents or who present with symptoms of B12 deficiency, this study does not support routine monitoring of B12 levels for patients with duration of therapy of 4 years or less.
2型糖尿病和胃食管反流病在美国极为常见。这两种疾病状态的一线治疗药物分别为二甲双胍和质子泵抑制剂。这两种药物都与维生素B12吸收减少有关。
本研究的目的是评估接受二甲双胍和质子泵抑制剂联合治疗的患者中维生素B12监测和补充的情况。
在一家联邦合格健康中心进行回顾性数据分析。纳入过去一年接受二甲双胍和质子泵抑制剂联合治疗（具体为奥美拉唑和泮托拉唑）的患者。收集的数据包括人口统计学信息、剂量、治疗持续时间和维生素B12水平。使用描述性统计方法分析数据。
共有104名患者符合本研究的纳入标准。二甲双胍1000毫克速释片是最常用的剂量和剂型。奥美拉唑和泮托拉唑是最常用的质子泵抑制剂。最常见的治疗持续时间为1至4年。14名患者有记录在案的维生素B12水平，且无患者被归类为缺乏。7名患者在研究期间被开具了维生素B12补充剂。
在这个单一中心，对接受二甲双胍和质子泵抑制剂联合治疗的患者进行回顾性病历审查，两种药物的平均治疗持续时间为1 - 4年。只有13.5%的患者有记录在案的维生素B12水平。在这些患者中，没有患者被归类为缺乏。虽然对于长期接受这两种药物治疗或出现维生素B12缺乏症状的患者，常规监测维生素B12水平可能很重要，但本研究不支持对治疗时间在4年或更短的患者进行常规维生素B12水平监测。
