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

Gastroenterology. 2017 Sep;153(3):678-680.e2. doi: 10.1053/j.gastro.2017.06.006. Epub 2017 Jun 15.

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.

Keywords: Hereditary Hemochromatosis; Proton Pump Inhibitors; Randomized Clinical Trial.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • 2-Pyridinylmethylsulfinylbenzimidazoles / therapeutic use*
  • Adult
  • Double-Blind Method
  • Female
  • Ferritins / blood
  • Hemochromatosis / blood
  • Hemochromatosis / genetics*
  • Hemochromatosis / therapy*
  • Hemochromatosis Protein / genetics*
  • Homozygote
  • Humans
  • Male
  • Middle Aged
  • Pantoprazole
  • Phlebotomy / statistics & numerical data
  • Proton Pump Inhibitors / therapeutic use*

Substances

  • 2-Pyridinylmethylsulfinylbenzimidazoles
  • HFE protein, human
  • Hemochromatosis Protein
  • Proton Pump Inhibitors
  • Ferritins
  • Pantoprazole

Associated data

  • ClinicalTrials.gov/NCT01524757