Proton Pump Inhibitors Decrease Phlebotomy Need in HFE Hemochromatosis: Double-Blind Randomized Placebo-Controlled Trial.

Annick Vanclooster, Cees van Deursen, Reggy Jaspers, David Cassiman, Ger Koek

Journal: Gastroenterology 2017;153(3):678-680.e2

PMID: 28624580

Full Text on Elsevier Science View on PubMed

Abstract

Phlebotomy constitutes the established treatment for HFE-related hemochromatosis. Retrospective studies have suggested proton pump inhibitors (PPIs) reduce the need for phlebotomy in this population. We conducted a randomized controlled trial to prove this. Thirty p.C282Y homozygous patients were randomly allocated to PPI (pantoprazole 40 mg/day) or placebo for 12 months. Phlebotomies were performed when serum ferritin was > 100 μg/L. Phlebotomy need turned out to be significantly lower in patients taking PPI (P = .0052). PPI treatment significantly reduces the need for phlebotomies in p.C282Y homozygous patients. In view of the known long-term safety profile of PPI, they can be a valuable addition to standard therapy. Clinicaltrials.gov: NCT01524757.

Address: Department of Gastroenterology-Hepatology and Metabolic Center, University Hospital Leuven, Belgium.; Department of Internal Medicine, Gastroenterology and Clinical Geriatrics, Zuyderland Medical Center, Heerlen, The Netherlands; Department of Internal Medicine, Division of Gastroenterology and Hepatology, Maastricht UMC+, The Netherlands.; Department of Gastroenterology, Laurentius Hospital Roermond, Roermond, The Netherlands.; Department of Internal Medicine, Division of Gastroenterology and Hepatology, Maastricht UMC+, The Netherlands; Nutrition and Translational Research in Metabolism (NUTRIM), University Maastricht, The Netherlands; Department of Surgery, University Hospital of the RWTH, Aachen, Germany. Electronic address: [email protected].

DOI: 10.1053/j.gastro.2017.06.006

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MeSH Terms: 2-Pyridinylmethylsulfinylbenzimidazoles, Adult, Double-Blind Method, Female, Ferritins, Hemochromatosis, Hemochromatosis Protein, Homozygote, Humans, Male, Middle Aged, Pantoprazole, Phlebotomy, Proton Pump Inhibitors