Assessment of effectiveness of different dosage regimens of pantoprazole in controlling symptoms and healing esophageal lesions of patients with mild erosive esophagitis

Abstract

-Background -Gastroesophageal reflux disease is a very common affection, and esophageal involvement is particularly frequent. The means to effectively control symptoms and improve esophageal inflammation in these patients is to reduce esophageal acid exposure. For this purpose, we use gastric proton pump inhibitor, that can suppress gastric acid secretion. Aim -To compare the effectiveness of two different pantoprazole dosage regimens (20 and 40 mg/day), in controlling symptoms and healing esophageal lesions of patients with mild erosive esophagitis. Material and Methods -Fiftyseven patients with endoscopically confirmed mild erosive esophagitis characterized as non-confluent erosions in the distal esophagus, were randomly to be treated either with pantoprazole 20 mg/day (group I, 28 patients) or 40 mg/day (group II, 29 patients) over a period of 4 weeks. After treatment completion, the patients were assessed for clinical and endoscopic outcome, i.e., absence of erosions in distal esophagus and improvement of gastroesophageal reflux symptoms. Results -At the end of the treatment, 73.1% of the patients in group I and 85.7% of the patients in group II had endoscopic improvement. We also observed, that 88.5% of the patients in group I and 92.9% of the patients in group II had complete elimination of heartburn and regurgitation. Conclusion -Pantoprazole dosage regimens of 20 mg/day and 40 mg/day provide equivalent effectiveness in controlling symptoms and healing esophageal lesions of mild esophagitis.

Novel Measurement of Rapid Treatment Success with ReQuestTM: First and Sustained Symptom Relief as Outcome Parameters in Patients with Endoscopy-Negative GERD Receiving 20 mg Pantoprazole or 20 mg Esomeprazole

“…PPIs are the current treatment of choice for patients with GERD; PPI treatment provides the most rapid symptomatic control of all available agents, and this study is in accordance with the literature showing that treatment effect can be achieved within a matter of days [1, 2, 29, 30]. In patients with erosive GERD, Castell et al [22] reported a median time to first resolution of diary-recorded heartburn of 2 days and a median time to sustained resolution of diary-recorded heartburn of 7 days, with 40 mg esomeprazole (ITT population).…”

Factors influencing treatment outcome in patients with gastroesophageal reflux disease: outcome of a prospective pragmatic trial in Asian patients

“…However, to replicate clinical practice where treatment is usually started on the basis of clinical history rather than endoscopy, a 40 mg dose of pantoprazole was chosen for all patients in this study. The higher dosage used in NERD patients could have potentially increased response rates, although the impact of this is likely to be small as previous studies have shown similar symptom response rates with pantoprazole 20 and 40 mg, even in patients with mild GERD [25]. The study had a pragmatic trial design and patients were enrolled in the trial on the basis of a clinical history of GERD, which allowed for the collection of data relevant to daily clinical practice, unlike trials of explanatory design, which may enroll a patient population that is not representative of that being treated in ordinary practice [10, 11].…”

Maintenance Treatment for GERD: Residual Symptoms Are Associated with Psychological Distress

“…For maximal efficacy PPIs should be taken approximately 30 min prior to a meal [26, 27]; suboptimal dosage timing was highly prevalent in primary care patients with poorly controlled GERD [28]. Especially in primary care, limited benefits of a double dosage on healing rates and relief of heartburn were reported [29,30,31]. …”