Oral pantoprazole for erosive esophagitis: a placebo-controlled, randomized clinical trial

Richter, Joel E.; Bochenek, Wieslaw

doi:10.1111/j.1572-0241.2000.03254.x

Cited by 98 publications

(67 citation statements)

References 14 publications

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“…The efficacy of PPIs in the management of nighttime heartburn has been documented in placebo-controlled studies [20, 21]. In the US Gallup survey, satisfaction with prescription medication was markedly higher than with over-the-counter medication or with lifestyle changes such as avoiding meals before going to bed or elevating the head of the bed [7].…”

Section: Discussionmentioning

confidence: 99%

Nighttime Heartburn in Patients with Gastroesophageal Reflux Disease under Routine Care

et al. 2008

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Background: Gastroesophageal reflux disease (GERD) is a common disorder. The aim of our study was to describe the prevalence of nighttime heartburn and its associations with esophagitis, Barrett’s esophagus, and extra-esophageal symptoms. Methods: Data were collected as part of the ongoing Progression of Gastroesophageal Reflux Disease (ProGERD) study. Based on endoscopy results, patients were categorized as having nonerosive GERD, erosive GERD, or Barrett’s esophagus. ORs and 95% CIs derived from logistic regression analysis were calculated for the association between nighttime heartburn and GERD complications. Results: The overall prevalence of nighttime heartburn for at least 1 of 3 years was 49%, and 21% of patients reported nighttime heartburn in all 3 years. According to multivariate analysis, chronic nighttime heartburn was associated with globus sensation (OR 1.79, 95% CI 1.29–2.47) and erosive GERD (OR 1.67, 95% CI 1.29–2.15). Compared to continuous proton pump inhibitor (PPI) intake, noncontinuous PPI therapy (OR 2.26, 95% CI 1.73–2.96) and medication other than PPIs (OR 2.46, 95% CI 1.67–3.62) were also associated with chronic nighttime heartburn. Conclusions: The prevalence of nighttime heartburn in GERD patients under routine care was high, even in patients on continuous PPI therapy. Nighttime heartburn was not associated with Barrett’s esophagus or most extra-esophageal symptoms.

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Section: Discussionmentioning

confidence: 99%

Nighttime Heartburn in Patients with Gastroesophageal Reflux Disease under Routine Care

et al. 2008

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“…Proton pump inhibitor (PPI) is the most effective treatment of GERD [12,13,14]. Daily PPI therapy results in healing of about 80% of moderate-to-severe reflux oesophagitis [15,16,17]. GERD is less prevalent in Asian countries and the perception is that Asians tend to have a milder spectrum of the disease.…”

Section: Discussionmentioning

confidence: 99%

Symptom Resolution Does Not Predict Healing of Erosive Oesophagitis in Chinese

Cheung¹,

Wong²,

Wong³

et al. 2007

Digestion

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Background: Previous studies suggested that Chinese have a milder spectrum of gastro-oesophageal reflux disease and a lower dose of proton pump inhibitors (PPI) is sufficient for the control of symptoms as compared with the Western population. Aims: To determine if 8 weeks of esomeprazole 20 mg daily would be adequate for both symptom resolution and oesophagitis healing in Chinese patients and the predictive factors for the response. Methods: 66 patients with oesophagitis were included. Oesophagitis severity was graded by Los Angeles (LA) classification. 61 patients underwent 24-hour ambulatory pH study at baseline. All were given esomeprazole 20 mg daily for 8 weeks. Symptom response and healing of oesophagitis was assessed at the end of the treatment period. Results: 75.8% of the patients had complete reflux symptom resolution but only 48% had complete healing of the oesophagitis at endoscopy after 8 weeks of treatment. LA classification grading at baseline endoscopy (p < 0.0001) and total number acid reflux episodes on 24-hour pH monitoring prior to treatment (p = 0.007) were both good predictors of oesophagitis healing but not for symptom resolution. Conclusions: Our results suggested that 8 weeks of lower dose PPI is not sufficient for oesophagitis healing. Symptom resolution with PPI does not predict oesophagitis healing in Chinese.

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“…Several studies [20,21,22,23,24] show that 88–96% of patients with reflux esophagitis present with normal endoscopic findings after 8 weeks of therapy with standard dose PPIs, regardless of the brand of PPIs and the severity of mucosal damage. Carlsson et al [9] also showed that approximately 27% of 225 patients with reflux esophagitis continue to experience heartburn, despite complete mucosal healing.…”

Section: Epidemiologymentioning

confidence: 99%

Refractory Heartburn to Proton Pump Inhibitors: Epidemiology, Etiology and Management

Sgouros

Mantides²

2006

Digestion

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Patients with refractory heartburn to proton pump inhibitors (PPIs) represent a distinctive group which is difficult to manage. In a systematic review of the relative literature we found that approximately 20% of patients with erosive esophagitis and 15–25% of patients with normal endoscopy and abnormal 24-hour esophageal pH monitoring continue to report heartburn despite treatment with standard dose PPIs. Furthermore, approximately 30–40% of patients with normal endoscopy and 24-hour pH studies and 15–20% of patients with Barrett’s esophagus have refractory heartburn to double dose PPIs. In such cases, compliance to therapy, duodeno-gastroesophageal reflux, gastro-esophageal motility disorders and eradication of Helicobacter pylori infection may contribute to symptoms. Based on the available evidence, we suggested an algorithm for the evaluation and management of these patients.

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Oral pantoprazole for erosive esophagitis: a placebo-controlled, randomized clinical trial

Abstract: Pantoprazole was safe and effective for healing erosive esophagitis and provided rapid symptomatic relief. These results indicate that pantoprazole offers a new option for treatment of erosive esophagitis. Among the three doses studied, the 40-mg dose was the most effective.

Cited by 98 publications

References 14 publications

Nighttime Heartburn in Patients with Gastroesophageal Reflux Disease under Routine Care

Nighttime Heartburn in Patients with Gastroesophageal Reflux Disease under Routine Care

Symptom Resolution Does Not Predict Healing of Erosive Oesophagitis in Chinese

Refractory Heartburn to Proton Pump Inhibitors: Epidemiology, Etiology and Management

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