Comparison of rabeprazole 20 mg versus omeprazole 20 mg in the treatment of active duodenal ulcer: a European multicentre study

Abstract

Background: Rabeprazole sodium is the newest member of a class of substituted benzimidazole molecules known as proton pump inhibitors. Other proton pump inhibitors have been shown to be effective in healing active duodenal ulcer. Method: This randomized, double‐blind, multicentre study, conducted at 25 European sites, compared the efficacy and tolerability of rabeprazole and omeprazole in patients with active duodenal ulcers. One hundred and two patients with active duodenal ulcer received rabeprazole 20 mg and 103 patients omeprazole 20 mg once daily for 2 or 4 weeks, with ulcer healing monitored by endoscopy. Results: After 2 weeks, complete ulcer healing was documented in 69% of patients given rabeprazole 20 mg and in 62% of patients given omeprazole 20 mg (N.S.). After 4 weeks, healing rates were 98% in the rabeprazole group and 93% in the omeprazole group (P = 0.083). Rabeprazole‐treated patients had significantly greater improvement in daytime pain symptom relief than those treated with omeprazole at the conclusion of the study (P = 0.038). Both drugs were well tolerated over the 4‐week treatment period. Mean changes from baseline to end‐point in fasting serum gastrin were significantly greater in the rabeprazole group, but at end‐point mean values were well within normal limits for both groups. No clinically meaningful changes or other between‐group differences were observed in laboratory parameters. Conclusion: In this study, rabeprazole produced healing rates equivalent to omeprazole at weeks 2 and 4, and provided significantly greater improvement in daytime pain. Both treatments were well tolerated.

Comparison of the kinetic disposition of and serum gastrin change by lansoprazole versus rabeprazole during an 8-day dosing scheme in relation to CYP2C19 polymorphism

“…Several comparative studies [21,22,23,24,25,26] of the pharmacokinetics, potency, acid suppression, clinical ecacy, and toxicity have been performed previously and have addressed the appropriate use of PPIs in the treatment of acid-related diseases. Unfortunately, none of these clinical studies [21,22,23,24,25,26] have taken into account the genetic polymorphism of CYP2C19, a major enzyme for the metabolism of PPIs in the liver [1,2,10]. Therefore, we were prompted to assess whether the kinetic and dynamic pro®les would dier between lansoprazole and rabeprazole in light of the genetically determined CYP2C19 polymorphism.…”

Safety and efficacy of 7‐day rabeprazole‐ and omeprazole‐based triple therapy regimens for the eradication of Helicobacter pylori in patients with documented peptic ulcer disease

“…11 In randomized, parallel-group clinical trials, rabeprazole was superior to placebo and ranitidine and as effective as omeprazole in the healing of duodenal and gastric ulcers. [12][13][14][15] In terms of H. pylori eradication, the effectiveness of rabeprazole-based triple therapy has been shown in patients with chronic gastritis, peptic ulcer disease and non-ulcer dyspepsia. [16][17][18][19][20] The present study was designed to determine whether rabeprazole, in combination with clarithromycin and either amoxicillin or metronidazole, is therapeutically equivalent to the same omeprazole-based regimens in the eradication of H. pylori in subjects with documented peptic ulcer disease and H. pylori infection.…”

The Clinical Importance of Proton Pump Inhibitor Pharmacokinetics

“…Rabeprazole 20 mg has also been compared with omeprazole 20 mg in this setting. There was no significant difference in healing between the two agents, but symptom relief was superior with rabeprazole [65]. No studies of esomeprazole are available in this setting.…”