Robin Warren (b. 1937), Barry Marshall (b. 1951)
The search for relief from often highly distressful acid-related disorders accounts for the proton pump inhibitors (PPIs) being among the world’s best-selling drugs. The PPIs are highly effective and generally safe drugs used for the healing of peptic ulcers and treatment of GERD and heartburn, which afflict half the adult population in Western countries on at least an occasional basis. In 1989, Prilosec (omeprazole), the first PPI, appeared.
Both the PPIs and the histamine H2 receptor blockers, such as Tagamet, reduce the production of stomach acid, although they act in different ways. The PPIs, which reduce the production of gastric acid for longer periods, are more effective and overwhelmingly preferred. Their use is not without hazard, however. In 2010, it was reported that extended use of PPIs increased the risk of fractures involving the wrist, hips, and spine by 25 percent.
Antacids, Tagamet, and Prilosec all produce temporary relief of peptic ulcers although the symptoms return periodically. In 1981, Australian pathologist Robin Warren and physician Barry Marshall provided evidence that nondrug-induced stomach and intestinal ulcers were caused by a Helicobacter pylori infection. This bacterial infection is thought to be responsible for 80–90 percent of all such cases. For their work, Warren and Marshall received the 2005 Nobel Prize in Physiology or Medicine. It is now standard treatment to combine an acid-reducing drug with an antibiotic to cure this bacterial infection and prevent a recurrence of the ulcer.
Considering the sales potential of the PPIs, it should not be surprising that their manufacturers have been extremely resourceful in their marketing strategies. Depending on the country where they are sold, some of these drugs require a prescription, while others may be obtained with or without a prescription. Consider another marketing approach: With the expiration of AstraZeneca’s patent on Prilosec in 2002, and with far less expensive generic equivalents on the horizon, the company introduced and very aggressively and successfully marketed Nexium to physicians and the public. Nexium is virtually identical to Prilosec, no more effective, not available generically, and far more expensive.
SEE ALSO Flagyl (1959), Tagamet (1976).
This highly magnified micrograph of gastritis (inflammation of the stomach lining) shows an infection of bacteria Helicobacter pylori.