Hughes Michael, Allanore Yannick, Baron Murray, Del Galdo Francesco, Denton Christopher P, Frech Tracy, Furst Daniel E, Galetti Ilaria, Dagna Lorenzo, Herrick Ariane L, Kuwana Masataka, Matucci-Cerinic Pietro, McMahan Zsuzsanna H, Murray Charles D, Proudman Susanna, Matucci-Cerinic Marco
Tameside Hospital, Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton-under-Lyne, United Kingdom.
Division of Musculoskeletal and Dermatological Sciences, The University of Manchester, Manchester, United Kingdom.
Lancet Rheumatol. 2022 Nov;4(11):e795-e803. doi: 10.1016/S2665-9913(22)00183-7. Epub 2022 Jul 25.
Gastroesophageal reflux disease (GERD) is associated with significant morbidity in patients with systemic sclerosis (SSc). Although the introduction of proton pump inhibitors (PPIs) into clinical care have represented a major achievement in the management of oesophago-gastric problems in SSc, PPIs are seldom fully effective in SSc patients, and the utilization of maximum PPI dosages is a very frequent clinical practice. However, currently there is little evidence currently to support the empiric use of PPIs in SSc which is especially relevant in regard to safety concerns of long-term exposure with have been raised in the general population. The purpose of this viewpoint is to highlight the significant beneficial impact of PPIs on GERD in SSc, while considering the potential adverse effects in this patient population. Furthermore, we highlight the unmet needs of SSc patients with GERD, and also propose an agenda for future research to optimise the safe and effective use of PPIs in SSc.
胃食管反流病（GERD）与系统性硬化症（SSc）患者的显著发病率相关。尽管质子泵抑制剂（PPI）引入临床治疗是系统性硬化症食管胃问题管理方面的一项重大成就，但PPI在SSc患者中很少能完全有效，且使用最大PPI剂量是非常常见的临床做法。然而，目前几乎没有证据支持在SSc中经验性使用PPI，这在一般人群中已引发长期暴露安全性担忧的背景下尤其相关。本观点文章的目的是强调PPI对SSc中GERD的显著有益影响，同时考虑该患者群体的潜在不良反应。此外，我们强调了GERD的SSc患者未满足的需求，并提出了未来研究议程，以优化PPI在SSc中的安全有效使用。
