Pantoprazole and omeprazole in the treatment of reflux oesophagitis: a European multicentre study

Abstract

S U M M A R YBackground: Pantoprazole is a new substituted benzimidazole which inhibits gastric H+,K+-ATPase. Methods : In this double-blind, multicentre study, pantoprazole 40 mg once daily was compared with omeprazole 20 mg once daily in the treatment of grade I1 and 111 (Savary-Miller) reflux oesophagitis. Endoscopy was repeated after 4 weeks of treatment, and also after 8 weeks in patients unhealed at 4 weeks. Results: The primary efficacy variable was ulcer healing; after 4 weeks, 81/103 (78.6%) patients in the pantoprazole group and 83/105 (79.0%) patients in the orneprazole group had healed completely. After 8 weeks, the cumulative healing rates were 94.2% and 91.4 % in the pantoprazole and omeprazole groups, respectively (P > 0.05 at 4 weeks and 8 weeks). Both groups experienced rapid relief of the key symptoms: heartburn, acid regurgitation and pain on swallowing. The time course of relief of the individual symptoms was similar in both groups after 2 and 4 weeks (P > 0.05). Both treatments were well tolerated, with only three patients withdrawing owing to adverse events. Conclusion: Pantoprazole has been shown to be as effective as omeprazole in the treatment of reflux oesophagitis. 0 199 5 Blackwell Science Ltd 667

A Multicenter, Randomized, Double-Blind, 8-Week Comparative Trial of Standard Doses of Esomeprazole (40 mg) and Omeprazole (20 mg) for the Treatment of Erosive Esophagitis

“…However, in this study, the healing rate for 40 mg esomeprazole was significantly higher than that for 20 mg omeprazole only in patients with moderate or severe EE. It is noteworthy that treatment with omeprazole yielded healing rates in this trial that were in the upper range of that reported in the literature (74%-94%) [13][14][15][16][17]. This wide range of reported 8-week EE healing rates with omeprazole is likely due to varying study designs, sample size, EE classification systems, and geographic locations.…”

A Multicenter, Randomized, Double-Blind, 8-Week Comparative Trial of Low-Dose Esomeprazole (20 mg) and Standard-Dose Omeprazole (20 mg) in Patients with Erosive Esophagitis

“…Surprisingly, the betweentreatment differences in healing rates were greatest for LA grades A (6.9%) and D (4.4%), which are at opposite ends of the LA classification severity spectrum. The healing rate at week 8 with omeprazole (88.3%) observed in this trial is at the high end of the range of healing rates previously reported (74% to 94%) [12][13][14][15]. This wide range of reported 8-week EE healing rates with omeprazole is likely due to varying study designs, sample size, EE classification systems, and geographic locations or may be related to the wide interpatient variability observed with the agent.…”

Pantoprazole: a proton pump inhibitor with oral and intravenous formulations

“…Finally, a study looking at higher doses found no significant benefit in healing when the dose of pantoprazole was increased from 40 to 80 mg [29]. When pantoprazole 40 mg was compared with omeprazole 20 or 40 mg once daily, there were no significant differences in esophagitis healing rates [30][31][32]. In addition, similar healing rates were found when pantoprazole 40 mg was compared with esomeprazole 40 mg [33,34], or lansoprazole 30 mg [35].…”

“…Asymptomatic elevations in liver enzymes, plasma lipoproteins and blood glucose have also been reported [39,82]. In comparative trials, there were no differences in the tolerability of pantoprazole when compared with omeprazole [30] and lansoprazole [34]. One study suggested the rate of community-acquired pneumonia to be higher in patients on acid-suppressing drugs [83].…”