No clinical benefit of adding cisapride to pantoprazole for treatment of gastro-oesophageal reflux disease

Rensburg, C. J. Van; Bardhan, K D

doi:10.1097/00042737-200108000-00006

Cited by 22 publications

(6 citation statements)

References 14 publications

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“…Similar rates of adverse events (most of which were assessed as unrelated to the study drug) occurred in both treatment groups. Patient compliance with both study drugs was high (99.7% of the drug was taken), and in agreement with other reports 25 ,. 28 , 32 , 33 …”

Section: Discussionsupporting

confidence: 92%

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Once‐daily pantoprazole 40 mg and esomeprazole 40 mg have equivalent overall efficacy in relieving GERD‐related symptoms

Scholten

Gatz²,

Hole³

2003

Aliment Pharmacol Ther

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SUMMARYAim: To compare the efficacy of pantoprazole and esomeprazole for the treatment of gastro-oesophageal reflux disease-(GERD-) related symptoms. Methods: In this multicentre, randomized, double-blind study 217 patients [intention-to-treat (ITT) Patients recorded GERD-related symptoms (daytime and night-time) using diaries (daily), and/or by telephone interviews (every third day) and completed the Gastrointestinal Symptom Rating Scale (GSRS) questionnaire. The area under the time curve (AUC) for the sum score of GERD-related symptoms (symptom load of each patient during the treatment) and the time to reach adequate relief from GERD-related symptoms were calculated. Results: Patients reported first adequate relief from daytime GERD-related symptoms after a mean of 3.7 (pantoprazole) and 5.9 days (esomeprazole) (P ¼ 0.034); the values for the night-time were 1.7 and 3.5 days, respectively (P ¼ 0.012, ITT). The AUCs for the single symptoms and the sum scores were comparable. Conclusions: Treatment with pantoprazole resulted in significantly faster first-time relief from daytime and night-time GERD-related symptoms than esomeprazole. Pantoprazole and esomeprazole were similar with respect to reduction of load of GERD-related symptoms.

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Section: Discussionsupporting

confidence: 92%

“…Several studies have previously reported a marked improvement in the symptoms of GERD during 4 weeks of treatment with pantoprazole 24–26 . Similarly, with esomeprazole, symptom relief rates of 65–68% have been reported 27 .…”

Section: Discussionmentioning

confidence: 87%

Once‐daily pantoprazole 40 mg and esomeprazole 40 mg have equivalent overall efficacy in relieving GERD‐related symptoms

Scholten

Gatz²,

Hole³

2003

Aliment Pharmacol Ther

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“…The standard dose of a PPI plus cisapride (withdrawn from clinical use due to a cardiac adverse effect) is reported to have no significant additional benefit in curing or relieving symptoms of GERD [82]. A Japanese study showed the possibility of an additional benefit of mosapride with a PPI [76].…”

Section: Cq: Is An Acid Suppressant Effective For the Treatment Of Gerd?mentioning

confidence: 99%

Evidence-based clinical practice guidelines for gastroesophageal reflux disease 2015

et al. 2016

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As an increase in gastroesophageal reflux disease (GERD) has been reported in Japan, and public interest in GERD has been increasing, the Japanese Society of Gastroenterology published the Evidence-based Clinical Practice Guidelines for GERD (1st edition) in 2009. Six years have passed since its publication, and there have been a large number of reports in Japan concerning the epidemiology, pathophysiology, treatment, and Barrett's esophagus during this period. By incorporating the contents of these reports, the guidelines were completely revised, and a new edition was published in October 2015. The revised edition consists of eight items: epidemiology, pathophysiology, diagnosis, internal treatment, surgical treatment, esophagitis after surgery of the upper gastrointestinal tract, extraesophageal symptoms, and Barrett's esophagus. This paper summarizes these guidelines, particularly the parts related to the treatment for GERD. In the present revision, aggressive proton pump inhibitor (PPI) maintenance therapy is recommended for severe erosive GERD, and on-demand therapy or continuous maintenance therapy is recommended for mild erosive GERD or PPI-responsive non-erosive GERD. Moreover, PPI-resistant GERD (insufficient symptomatic improvement and/or esophageal mucosal break persisting despite the administration of PPI at a standard dose for 8 weeks) is defined, and a standard-dose PPI twice a day, change in PPI, change in the PPI timing of dosing, addition of a prokinetic drug, addition of rikkunshito (traditional Japanese herbal medicine), and addition of histamine H2-receptor antagonist are recommended for its treatment. If no improvement is observed even after these treatments, pathophysiological evaluation with esophageal impedancepH monitoring or esophageal manometry at an expert facility for diseases of the esophagus is recommended.

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“…In most cases proton pump inhibitors (PPIs) achieve the desired acid suppression when given once daily, they are widely accepted to be the best treatment option. It is generally accepted that PPIs are significantly superior to H 2 -receptor antagonists [5, 6, 7, 8], prokinetics [9]and placebo [for review see 10, 11, 12]. Further, it was previously shown that pantoprazole and omeprazole are highly efficacious in the treatment of mild [13]and moderate to severe GERD [14, 15].…”

Section: Introductionmentioning

confidence: 99%

Comparable Efficacy of Pantoprazole and Omeprazole in Patients with Moderate to Severe Reflux Esophagitis

et al. 2003

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Aim: To compare the efficacy and tolerability of pantoprazole 40 mg and omeprazole MUPS 40 mg in patients with moderate to severe gastroesophageal reflux disease (GERD). Methods: In this randomized, double-blind, parallel-group, multicenter study conducted in Austria, Germany, Portugal, Switzerland and The Netherlands, patients with endoscopically confirmed moderate to severe GERD (Savary/Miller esophagitis grade II/III) were enrolled. They received a once-daily dose of either 40 mg pantoprazole or 40 mg omeprazole MUPS. Healing was determined by endoscopy after 4 weeks of treatment. If patients were not healed, treatment was extended for another 4 weeks. An additional endoscopy was performed in these cases after 8 weeks of treatment. Healing was determined by endoscopy after 4 and 8 weeks. In addition, treatment effect on symptoms was evaluated by the investigator using a questionnaire assessing heartburn, reflux regurgitation and pain on swallowing at each visit, as well as by a self-administered questionnaire comprising further 24 gastrointestinal symptoms. Analyses were performed for the intention-to-treat (ITT) and the per-protocol (PP) population. In addition, patients with high compliance (HC: 90% ≤110%) were considered in a separate group. Adverse events and the influence of the Helicobacter pylori status were investigated. Results: A total of 669 outpatients were enrolled in the study, with 337 patients receiving pantoprazole and 332 omeprazole MUPS. The PP population consisted of 552 patients, 282 treated with pantoprazole and 270 with omeprazole MUPS. The healing rates in both treatment groups were shown to be equivalent and were higher in patients who adhered closely to the administration protocol (HC). According to ITT (ITT_HC) analyses, healing rates were 65.3% (77.4%) in the pantoprazole and 66.3% (74.7%) in the omeprazole group after 4 weeks. Furthermore, patients infected with H. pylori had slightly but not significantly higher healing rates than those with a negative test result. The safety profile of both treatments was comparable. Conclusion: Pantoprazole 40 mg and omeprazole MUPS 40 mg were equivalent with respect to healing after 4 and 8 weeks of treatment in patients with reflux esophagitis grade II/III. Overall, HC patients had higher healing rates than the regular compliant patients. Both drugs were well tolerated and safe.

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No clinical benefit of adding cisapride to pantoprazole for treatment of gastro-oesophageal reflux disease

Abstract: Addition of cisapride to pantoprazole provides no further benefit in the treatment of GORD.

Cited by 22 publications

References 14 publications

Once‐daily pantoprazole 40 mg and esomeprazole 40 mg have equivalent overall efficacy in relieving GERD‐related symptoms

Once‐daily pantoprazole 40 mg and esomeprazole 40 mg have equivalent overall efficacy in relieving GERD‐related symptoms

Evidence-based clinical practice guidelines for gastroesophageal reflux disease 2015

Comparable Efficacy of Pantoprazole and Omeprazole in Patients with Moderate to Severe Reflux Esophagitis

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