Comparative study of pantoprazole and esomeprazole for erosive gastroesophageal reflux disease: a prospective study
Keywords:
Erosive esophagitis, Las Angeles grade, Esomeprazole, PantoprazoleAbstract
Background: The objective of this study was to compare the efficacy of pantoprazole and esomeprazole to heal and relief from erosive esophagitis (EE) disease related symptoms.
Methods: One hundred and ten patients (IIT-patients) with EE were randomized to receive 8 weeks of 40 mg pantoprazole (n=55) twice before food for first 7 days followed by once daily and esomeprazole 40 mg (n=55) once daily. Daily changes in heartburn and reflux were assessed.
Results: The mean heartburn score with esomeprazole is more rapidly decreased than with pantoprazole. There no mild significant differences between two groups in the rate healing of reflux esophagitis at week and 4 and 8. The LA grade severity compare with esomeprazole group is rapidly decreased compared with pantoprazole. Esomeprazole 40 mg provided significantly greater healing than pantoprazole 40 mg after 4 weeks of treatment in patients with EE (56.36% vs. 49.09 %). Esomeprazole-treated patients were healed after up to 8 weeks of treatment similar those treated with pantoprazole (94.54% vs. 70.90 %).
Conclusion: Esomeprazole is more effective than pantoprazole for rapid relief of heartburn symptoms and acid reflux symptoms in patients with reflux esophagitis.
Metrics
References
Chen CY, Lu CL, Luo JC, Chang FY, Lee SD, Lai YL. Esomeprazole tablet vs. omeprazole capsule in treating erosive esophagitis. World J Gastroenterol. 2005;11(20):3112-7.
Fennerty MB. Medical treatment of gastroesophageal reflux disease in the managed care environment. Semin Gastrointest Dis. 1997;8(2):90-9.
Lundell LR, Dent J, Bennett JR, Blum AL, Armstrong D, Galmiche JP, et al. Endoscopic assessment of oesophagitis: clinical and functional correlates and further validation of the los Ange0020les classification. Gut. 1999;45(2):172-80.
Armstrong D, Veldhuyzen van Zanten SJ, Barkun AN, Chiba N, Thomson AB, Smyth S, et al. Heartburn-dominant, uninvestigated dyspepsia: a comparison of ‘PPI-start’ and ‘H2-RA-start’ management strategies in primary care – The CADET-HR Study. Aliment Pharmacol Ther. 2005;21(10):1189-202.
Labenz J, Armstrong D, Lauritsen K, Katelaris P, Schmidt S, Schütze K, et al. A randomized comparative study of esomeprazole 40 mg versus pantoprazole 40 mg for healing erosive oesophagitis: the EXPO study. Aliment Pharmacol Ther. 2005;21(6):739-46.
Gralnek IM, Dulai GS, Fennerty MB, Spiegel BM. Esomeprazole versus other proton pump inhibitors in erosive esophagitis: a meta-analysis of randomized clinical trials. Clin Gastroenterol Hepatol. 2006;4(12):1452-8.
Richter JE, Kahrilas PJ, Johanson J, Maton P, Breiter JR, Hwang C, et al. Efficacy and safety of esomeprazole compared with omeprazole in GERD patients with erosive esophagitis: a randomized controlled trial. Am J Gastroenterol. 2001;96(3):656-65.
Kahrilas PJ, Falk GW, Johnson DA, Schmitt C, Collins DW, Whipple J, et al. Esomeprazole improves healing and symptom resolution as compared with omeprazole in reflux oesophagitis patients: a randomized controlled trial. The Esomeprazole Study Investigators. Aliment Pharmacol Ther. 2000;14(10):1249-58.
Castell DO, Kahrilas PJ, Richter JE, Vakil NB, Johnson DA, Zuckerman S, et al. Esomeprazole (40 mg) compared with lansoprazole (30 mg) in the treatment of erosive esophagitis. Am J Gastroenterol. 2002;97(3):575-83.
Fennerty MB, Johanson JF, Hwang C, Sostek M. Efficacy of esomeprazole 40 mg vs. lansoprazole 30 mg for healing moderate to severe erosive oesophagitis. Aliment Pharmacol Ther. 2005;21(4):455-63.
Lundell LR, Dent J, Bennett JR, Blum AL, Armstrong D, Galmiche JP, et al. Endoscopic assessment of oesophagitis: clinical and functional correlates and further validation of the Los Angeles classification. Gut. 1999;45:172-80.
Ghillebert G, Demeyere AM, Janssens J, Vantrappen G. How well can quantitative 24-hour intraesophageal pH monitoring distinguish various degrees of reflux disease? Dig Dis Sci. 1995;40(6):1317-24.
Mittal RK, Holloway RH, Penagini R, Blackshaw LA, Dent J. Transient lower esophageal sphincter relaxation. Gastroenterology. 1995;109(2):601-10.
Kawano S, Murata H, Tsuji S, Kubo M, Tatsuta M, Iishi H, et al. Randomized comparative study of omeprazole and famotidine in reflux esophagitis. J Gastroenterol Hepatol. 2002;17(9):955-9.
Sachs G. Proton pump inhibitors and acid-related diseases. Pharmacotherapy. 1997;17(1):22-37.
Dimenäs E. Methodological aspects of evaluation of Quality of Life in upper gastrointestinal diseases. Scand J Gastroenterol Suppl. 1993;199:18-21.
Dimenäs E, Carlsson G, Glise H, Israelsson B, Wiklund I. Relevance of norm values as part of the documentation of quality of life instruments for use in upper gastrointestinal disease. Scand J Gastroenterol Suppl. 1996;221:8-13.
Simon B, Müller P, Pascu O, Gatz G, Sander P, Huber R, et al. Intra-oesophageal pH profiles and pharmacokinetics of pantoprazole and esomeprazole: a crossover study in patients with gastro-oesophageal reflux disease. Eur J Gastroenterol Hepatol. 2003;15(7):791-9.
Gillessen A, Beil W, Modlin IM, Gatz G, Hole U. 40 mg pantoprazole and 40 mg esomeprazole are equivalent in the healing of esophageal lesions and relief from gastroesophageal reflux disease-related symptoms. J Clin Gastroenterol. 2004;38(4):332-40.
Scholten T, Gatz G, Hole U. Once-daily pantoprazole 40 mg and esomeprazole 40 mg have equivalent overall efficacy in relieving GERD-related symptoms. Aliment Pharmacol Ther. 2003;18(6):587-94.
Miner P Jr, Katz PO, Chen Y, Sostek M. Gastric acid control with esomeprazole, lansoprazole, omeprazole, pantoprazole, and rabeprazole: a five-way crossover study. Am J Gastroenterol. 2003;98(12):2616-20.
Röhss K, Lind T, Wilder-Smith C. Esomeprazole 40 mg provides more effective intragastric acid control than lansoprazole 30 mg, omeprazole 20 mg, pantoprazole 40 mg and rabeprazole 20 mg in patients with gastro-oesophageal reflux symptoms. Eur J Clin Pharmacol. 2004;60(8):531-9.
Röhss K, Wilder-Smith C, Nauclér E, Jansson L. Esomeprazole 20 mg provides more effective intragastric Acid control than maintenance-dose rabeprazole, lansoprazole or pantoprazole in healthy volunteers. Clin Drug Investig. 2004;24(1):1-7.
Röhss K, Hasselgren G, Hedenström H. Effect of esomeprazole 40 mg vs. omeprazole 40 mg on 24-hour intragastric pH in patients with symptoms of gastroesophageal reflux disease. Dig Dis Sci. 2002;47(5):954-8.
Miner P Jr, Katz PO, Chen Y, Sostek M. Reanalysis of intragastric pH results based on updated correction factors for Slimline and Zinetics 24 single-use pH catheters. Am J Gastroenterol. 2006;101(2):404-5.