A Multicenter, Randomized, Double-Blind, 8-Week Comparative Trial of Standard Doses of Esomeprazole (40 mg) and Omeprazole (20 mg) for the Treatment of Erosive Esophagitis

Schmitt, Colleen M.; Lightdale, Charles J.; Hwang, Clara; Hamelin, Bettina A.

doi:10.1007/s10620-005-9062-4

Cited by 51 publications

(50 citation statements)

References 19 publications

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“…3b). Data on healing rate at 4 weeks were reported in 39 trials from 38 studies, 14,16,30,[32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67] and the network for these comparisons was constructed with 18 treatments (vonoprazan, six PPIs, four H 2 RAs, and placebo) ( Fig. 3c).…”

Section: Resultsmentioning

confidence: 99%

“…For the sensitivity analyses, studies were excluded from the analysis as follows: one study 32 due to a high risk of bias from attrition, seven studies 35,38,39,45,48,65,68 that calculated healing rates based on PPS, and two studies 50,62 with only life table (or Kaplan-Meier) estimated healing rates. Only 20 studies (22 trials) 14,16,30,31,35,[37][38][39][40]42,43,[49][50][51]62,64,66,[68][69][70] used the Los Angeles scale for endoscopic assessment and were eligible for this analysis. The results (both estimates and orders) of these analyses were consistent with the main analysis, showing its robustness (Table S3).…”

Section: Resultsmentioning

confidence: 99%

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Vonoprazan versus proton‐pump inhibitors for healing gastroesophageal reflux disease: A systematic review

Miyazaki

Igarashi

Takeuchi

et al. 2019

J of Gastro and Hepatol

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Background and Aim Gastroesophageal reflux disease (GERD) is a common disease caused by reflux of gastric contents to the esophagus. Proton‐pump inhibitors (PPIs) are recommended as a first‐line therapy to treat GERD. Recently, a new potassium‐competitive acid blocker, vonoprazan, was launched in Japan. We aimed to evaluate the comparative efficacy of vonoprazan and other PPIs in healing GERD. Methods We used MEDLINE and the Cochrane Central Register of Controlled Trials to search the literature. Double‐blind randomized controlled trials for PPIs and/or vonoprazan that were published in English or Japanese and assessed healing effects in adult GERD patients were included. To estimate the comparative efficacy of treatments, we performed a Bayesian network meta‐analysis to assess the consistency assumption. Results Of 4001 articles identified in the database, 42 studies were eligible. One study was hand‐searched and added to the analysis. For the main analysis of healing effects at 8 weeks, odds ratios (ORs) of vonoprazan (20 mg daily) to esomeprazole (20 mg), rabeprazole (20 mg), lansoprazole (30 mg), and omeprazole (20 mg) were 2.29 (95% credible interval, 0.79–7.06), 3.94 (1.15–14.03), 2.40 (0.90–6.77), and 2.71 (0.98–7.90), respectively. Subgroup analysis for patients with severe esophagitis at baseline showed significantly higher ORs for vonoprazan versus most of the comparator PPIs. Conclusions This analysis shows that the GERD healing effect of vonoprazan is higher than that of rabeprazole (20 mg) but not higher than other PPIs. Subgroup analysis indicated that vonoprazan is more effective than most PPIs for patients with severe erosive esophagitis.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Vonoprazan versus proton‐pump inhibitors for healing gastroesophageal reflux disease: A systematic review

Miyazaki

Igarashi

Takeuchi

et al. 2019

J of Gastro and Hepatol

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“…Several intragastric pH studies have shown that esomeprazole at a dose of 40 mg daily is superior to standard dosages of all other available original brand PPIs in controlling intragastric acidity, [3][4][5][6][7] while highdose esomeprazole was superior to high-dose pantoprazole in another study. 8 This functional superiority of esomeprazole is mirrored by significant clinical advantages over some other PPIs in healing and maintenance therapy of erosive GERD [9][10][11][12][13][14][15] whereas there were no differences when omeprazole was used in the treatment of non-erosive GERD. 16 Generic omeprazole has been approved and is being increasingly used for the treatment of GERD and other acid-related gastrointestinal disorders.…”

Section: Discussionmentioning

confidence: 99%

“…The subjects were considered healthy based on a detailed medical history, physical examination and routine laboratory assessment. Only subjects who were H. pylori-negative based on 13 C urea breath test (INFAI, Cologne, Germany) were eligible. Subjects with past or present significant illness and those with known intolerance to PPI were excluded.…”

Section: Subjectsmentioning

confidence: 99%

Intragastric acidity during administration of generic omeprazole or esomeprazole - a randomised, two-way crossover study including CYP2C19 genotyping

Miehlke¹,

Löbe

Madisch³

et al. 2010

Alimentary Pharmacology &Amp; Therapeutics

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“…Proton pump inhibitors (PPIs) are the treatment of choice for both healing and maintenance therapy of RE (8)(9)(10). Numerous studies have demonstrated the efficacy of PPIs for initial healing of RE (11)(12)(13)(14)(15)(16)(17)(18) and numerous separate studies have demonstrated the efficacy of PPIs for maintaining endoscopic remission (8,10). The EXPO study (14,15), which compared esomeprazole with pantoprazole, is one of the few clinical trials to follow patients with RE through the entire course of management, i.e.…”

Section: Introductionmentioning

confidence: 99%

Management of reflux esophagitis: does the choice of proton pump inhibitor matter?

Labenz

Armstrong

Leodolter³

et al. 2015

Int J Clin Pract

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Background: Proton pump inhibitors (PPIs) are the treatment of choice for reflux esophagitis (RE). The effectiveness of PPIs throughout RE management, from healing to maintenance, has not been fully studied. Aim: To compare esomeprazole with lansoprazole or pantoprazole for RE management using a management model. Methods: Data from six studies comparing esomeprazole with lansoprazole or pantoprazole for healing (4-8 weeks) or maintenance of healing (6 months) of RE were incorporated into hypothetical management models to determine the proportion of patients in endoscopic remission after sequential healing and maintenance therapy, assuming that patients received the same PPI throughout. The number needed to treat (NNT) to achieve one more patient in remission with esomeprazole vs. other PPIs was estimated. The hypothetical model was validated using results from the EXPO study, which compared esomeprazole with pantoprazole for RE healing and maintenance. Results: Overall, esomeprazole 40 mg produced higher rates of healing (life-table estimates) than lansoprazole 30 mg (82.4-92.6% vs. 77.5-88.8%; p < 0.01) or pantoprazole 40 mg (95.5% vs. 92.0%; p < 0.001) and higher rates of endoscopic and symptomatic remission at 6 months than lansoprazole (83.0-84.8% vs. 74.0-75.9%; p < 0.001; life-table estimates) or pantoprazole (70.9% vs. 59.6%; p < 0.0001; observed rates). In the hypothetical management model, the NNT for esomeprazole was 9 vs. lansoprazole and 8 vs. pantoprazole. The actual NNT for esomeprazole vs. pantoprazole in the EXPO study was 9 (95% confidence interval: 6; 16). Conclusions: In this management model, esomeprazole was more effective than either lansoprazole or pantoprazole for maintaining remission after sequential healing and 6 months' maintenance therapy for RE. What's knownNumerous studies have demonstrated the efficacy of proton pump inhibitors (PPIs) for initial healing of reflux esophagitis and maintenance of endoscopic remission. However, the effect of different PPIs in achieving healing and then maintaining remission has not been fully studied. What's newIn this management model, esomeprazole offers improved clinical efficacy compared with lansoprazole or pantoprazole throughout the course of management (i.e. initial healing of reflux esophagitis followed by maintenance of remission)

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A Multicenter, Randomized, Double-Blind, 8-Week Comparative Trial of Standard Doses of Esomeprazole (40 mg) and Omeprazole (20 mg) for the Treatment of Erosive Esophagitis

Cited by 51 publications

References 19 publications

Vonoprazan versus proton‐pump inhibitors for healing gastroesophageal reflux disease: A systematic review

Vonoprazan versus proton‐pump inhibitors for healing gastroesophageal reflux disease: A systematic review

Intragastric acidity during administration of generic omeprazole or esomeprazole - a randomised, two-way crossover study including CYP2C19 genotyping

Management of reflux esophagitis: does the choice of proton pump inhibitor matter?

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