Comparison of 24‐h control of gastric acidity by three different dosages of pantoprazole in patients with duodenal ulcer

Savarino, Vincenzo; Mela, Giuseppe Sandro; Zentilin, Patrizia; Bisso, G.; Pivari, Monica; Vigneri, Sergio; Termini, R; Fiorucci, Stefano; Usai, Paolo; Malesci, Alberto; Celle, G

doi:10.1046/j.1365-2036.1998.00416.x

Cited by 33 publications

(18 citation statements)

References 23 publications

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“…The prevalence of gastric H. pylori infection, a factor improving the response to proton pump inhibitors, 20 was comparable in the two groups, as was the prevalence of atypical manifestations of GERD, such as non‐cardiac chest pain and respiratory symptoms, conditions for which higher doses of proton pump inhibitors for acid suppression are often needed 8 , . 18 , 21–23 In our series, a double‐dose regimen of lansoprazole or omeprazole produced normalization of oesophageal acid exposure in all patients with persisting abnormal acid reflux while on a single‐dose regimen, in accordance with previous studies showing the dose–response relationship of proton pump inhibitors to gastric acid antisecretory effects 24–26 …”

Section: Discussionsupporting

confidence: 89%

Lansoprazole vs. omeprazole for gastro‐oesophageal reflux disease: a pH‐metric comparison

Frazzoni

Micheli

Grisendi

et al. 2002

Aliment Pharmacol Ther

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Background: Lansoprazole and omeprazole are widely used proton pump inhibitors for the management of gastro‐oesophageal reflux. Normalization of oesophageal acid exposure is an important goal in the management of complicated and atypical gastro‐oesophageal reflux disease. Aim: To compare the efficacy of lansoprazole and omeprazole in the abolition of abnormal reflux as assessed by oesophageal pH monitoring. Methods: Seventy patients with complicated or atypical gastro‐oesophageal reflux disease were randomly assigned to receive 30 mg lansoprazole or 20 mg omeprazole once daily. Three to four weeks after the start of treatment, patients underwent oesophageal pH monitoring while on therapy. If the results were still abnormal, the proton pump inhibitor dosage was doubled and 24‐h pH‐metry was repeated after 20–30 days. Results: Thirty‐six patients were randomized to receive lansoprazole and 34 patients to receive omeprazole. Ten of the 36 (29%) patients treated with 30 mg lansoprazole once daily and 23 of the 34 (68%) patients treated with 20 mg omeprazole once daily had persistently abnormal reflux at oesophageal pH monitoring (P < 0.001). In all such cases, repeat pH monitoring after doubling the proton pump inhibitor dosage gave normal results. Conclusions: At the currently marketed dosages of lansoprazole and omeprazole, normalization of oesophageal acid exposure in patients is accomplished more easily with lansoprazole.

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Section: Discussionsupporting

confidence: 89%

Lansoprazole vs. omeprazole for gastro‐oesophageal reflux disease: a pH‐metric comparison

Frazzoni

Micheli

Grisendi

et al. 2002

Aliment Pharmacol Ther

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“…0.05) between the duration of acid suppression and the proportion of healed (duodenal) ulcers', which both dose-dependently increased from 10 to 20 and further to 40 mg omeprazole over 4 weeks. The same dose-response relationship has been reported for pantoprazole in DU patients [137] and in pH-metry studies [112][113][114][115].…”

Section: Ppis Show Similar Dose-response Relationshipssupporting

confidence: 57%

Relative Efficacies of Gastric Proton Pump Inhibitors: Their Clinical and Pharmacological Basis

Kromer

Horbach²,

Lühmann³

1999

Pharmacology

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The present review will verify by intra-study rank orders, and their comparison between studies, that the different gastric proton pump inhibitors (PPIs) display similar dose-response relationships with similar potencies and efficacies on a milligram basis, i.e., at the same milligram doses. This is in line with their basic pharmacology which suggests that, primarily, the serum AUCs of the free pro-drugs and their chemical activation half lives at pH 1 relative to their serum elimination half lives determine the efficacies of PPIs. According to the literature, these drug characteristics are similar for all PPIs. Although PPIs have been introduced into the therapy of acute peptic ulcer disease at different daily, oral doses of 20 mg (omeprazole and rabeprazole), 30 mg (lansoprazole) and 40 mg (pantoprazole), the data suggest that the optimal dose of lansoprazole, omeprazole and pantoprazole, with respect to the acute treatment of peptic ulcers and moderate to severe gastroesophageal reflux disease (GERD), is about 30–40 mg daily. The data base of rabeprazole appears to be too small at present to make any definite statement. Lower daily doses of the PPIs of about 15–20 mg are sufficient in less severe cases of GERD and in maintenance therapy. It appears that different dose recommendations were based on different strategies to balance optimal drug dosage and safety, rather than on real differences in milligram-related efficacies.

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“…The lower night‐time pH relative to daytime values is a common finding, which has been reported previously in both patients and healthy volunteers taking proton pump inhibitors 22–26 . It has been suggested that, at least for omeprazole, the magnitude of the nocturnal acid breakthrough may be dependent upon the dosing regimen, with an evening dose resulting in less breakthrough than a morning dose 24 .…”

Section: Discussionmentioning

confidence: 62%

Dose‐dependent control of intragastric pH by pantoprazole, 10, 20 or 40 mg, in healthy volunteers

Tutuian

Katz

Bochenek

et al. 2002

Aliment Pharmacol Ther

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Background: Proton pump inhibitors have emerged as the most effective class of drugs for the treatment of gastro‐oesophageal reflux. Pantoprazole is a proton pump inhibitor that has demonstrated high clinical efficacy. Aim: To evaluate the effect of once‐daily doses of pantoprazole, 10, 20 and 40 mg, on gastric acidity in healthy volunteers. Methods: Thirty‐six subjects received pantoprazole in a three‐way crossover design study. Ambulatory 24‐h intragastric pH and distal oesophageal pH were monitored at baseline and on the last day of each treatment period. The measured endpoints were the median intragastric and oesophageal pH, the percentage of time the intragastric pH < 4 and oesophageal pH < 4 and the area under the curve for gastric acidity over 24 h. Safety was evaluated by incidence and severity of adverse events. Results: Pantoprazole demonstrated a linear dose‐ dependent suppression of gastric acidity over the dose range 10–40 mg. The dose of 40 mg demonstrated a significantly greater response than the lower doses, particularly at night. All pantoprazole doses were well tolerated. Conclusions: Pantoprazole demonstrates a dose‐related effect in the range 10–40 mg once daily. The once‐daily dose of 40 mg provides the highest and most consistent control of gastric pH, especially at night.

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Comparison of 24‐h control of gastric acidity by three different dosages of pantoprazole in patients with duodenal ulcer

Cited by 33 publications

References 23 publications

Lansoprazole vs. omeprazole for gastro‐oesophageal reflux disease: a pH‐metric comparison

Lansoprazole vs. omeprazole for gastro‐oesophageal reflux disease: a pH‐metric comparison

Relative Efficacies of Gastric Proton Pump Inhibitors: Their Clinical and Pharmacological Basis

Dose‐dependent control of intragastric pH by pantoprazole, 10, 20 or 40 mg, in healthy volunteers

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