Review Article: Efficacy and safety of rabeprazole in treating gastroesophageal reflux disease

Lim, Paul; Goh, Khean‐Lee

doi:10.1111/j.1440-1746.2004.03592.x

Cited by 6 publications

(3 citation statements)

References 38 publications

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“…In fact, like other PPIs, rabeprazole is metabolized by hepatic CYP2C19 enzymes. However, unlike other PPIs, rabeprazole metabolism involves CYP2C19 activity to a lesser extent [34]. Rabeprazole undergoes almost-complete hepatic metabolization, followed by renal elimination of its metabolites.…”

Section: Discussionmentioning

confidence: 99%

Monitoring Cytochrome P-450 Activity During Rabeprazole Treatment in Patients with Gastresophageal Reflux Disease

2006

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Proton pump inhibitors (PPIs) are the cornerstone in the treatment of gastresophageal reflux disease (GORD). PPIs are metabolized by the hepatic cytochrome P-450 enzymes (CYP-450). Rabeprazole is a PPI whose metabolism shows fewer interactions compared to other PPIs. In this study we evaluated the influence of rabeprazole administration on hepatic CYP-450 activity as measured by the (13)C-aminopyrine breath test ((13)C-ABT) in a group of patients with GORD. (13)C-ABT was performed on five GORD patients both before and after 1 week of rabeprazole administration (20 mg, b.i.d.). Pretreatment (13)C-ABT results were compared to posttreatment results. Pre- and posttreatment (13)C-ABT results for patients were compared to those obtained in five controls who did the test twice, with a 1-week interval in between. Before treatment, the (13)C-ABT results for the GORD patients did not significantly differ from those of healthy subjects. After treatment, we observed no significant modification of the (13)C-ABT in GORD patients compared to pretreatment values ((13)C-ABT %dose/hr, 10.56+/-1.31 versus 11.17+/-0.88; (13)C-ABT %cumulative dose, 8.08+/-1.11 versus 8.34+/-0.56). Posttreatment (13)C-ABT results were not significantly different from those obtained in controls at weekly repetition of the test. In patients with GORD, 1-week, full-dose rabeprazole does not display any significant interactions with CYP-450 activity.

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Section: Discussionmentioning

confidence: 99%

Monitoring Cytochrome P-450 Activity During Rabeprazole Treatment in Patients with Gastresophageal Reflux Disease

2006

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“…E-mail: guangjiwang@ hotmail.com PPI, omeprazole [8]. The results of clinical trials have demonstrated that rabeprazole is as effective as omeprazole in promoting ulcer healing and in alleviating gastroesophageal reflux disease (GERD) symptoms [9][10] and that it may provide superior pain relief [11].…”

Section: Introductionmentioning

confidence: 99%

Liquid chromatographic–mass spectrometry analysis and pharmacokinetic studies of a novel rabeprazole formulation, sterile powder for injection, in dogs and rats

Shao

Sun

Xie

et al. 2007

Biopharm & Drug Disp

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Rabeprazole is among the most potent proton pump inhibitors (PPI) identified to date and it has been demonstrated that it is effective in such diseases as gastroesophageal reflux disease (GERD), duodenal ulcer and gastric ulcer. There is currently interest in developing a new formulation: rabeprazole sterile powder for injection (RSPI). This investigation was conducted to evaluate the preclinical pharmacokinetics of RSPI in rats and at the same time a comparative study was carried out in dogs between RSPI and Pariet tablets using liquid chromatographic-mass spectrometry analysis. The liquid chromatographic-mass spectrometry method was first conducted and validated as being specific, and having accuracy, precision, sensitivity and a satisfactory recovery. After intravenous administration of RSPI (i.v.: 2, 6 and 18 mg/kg) to rats, no significant dose-dependency was found in the CL (4.20-5.72 l/h/kg), V(area) (d) (0.94-1.32 l/kg), dose-normalized AUC (197.20-245.82 microg/l*h based on 1 mg/kg) and t(1/2) (p>0.05). In the dog, a randomized, open-label, crossover experiment was carried out to show that the mean area under the plasma concentration-time curve (AUC(0-infinity)) after i.v. administration of RSPI was at least four times larger than that following oral administration of Pariet tablet at an equivalent dose but the elimination half-life of these two formulation was similar (p>0.05). The results showed that the pharmacokinetics of RSPI was linear (r(2) = 0.98) in the dose range 2-18 mg/kg and the RSPI had a much higher AUC(0-infinity) and similar t(1/2) values compared with the enteric-coated tablet.

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“…The potential for cost reduction is another issue to contend with. Rabeprazole, with its higher pKa, allows a greater build‐up in the parietal cells which results in faster and profound inhibition of acid secretion 26 …”

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confidence: 99%

The rising trend of on‐demand and intermittent proton pump inhibitor therapy in gastroesophageal reflux disease: What is the evidence?

Bautista

2006

J of Gastro and Hepatol

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Gastroesophageal reflux disease is a chronic and relapsing disease. Its symptoms do not correlate well with the degree of reflux events or injury that pose a challenge in its management. Thus far, treatment modalities include lifestyle and dietary modifications, antacids and anti-secretory medications, and anti-reflux surgery. With an erratic symptomatology, high cost of treatment, and fear of complications and side effects, the dilemma arises as to when treatment is stopped. Diverse therapeutic strategies continue to advance to address such concerns. The rising trend of on-demand and intermittent proton pump inhibitor therapy has raised various issues regarding efficacy.Gastroesophageal reflux disease (GERD) has been traditionally defined as chronic symptoms or mucosal damage produced by abnormal reflux of gastric contents into the esophagus. 1 The diversity of clinical manifestations ranges from typical symptoms of heartburn and acid regurgitation to atypical symptoms such as chest pain, asthma, chronic cough and hoarseness. 2 Being a chronic disease, primary endpoints of treatment include healing of esophagitis and prevention of complications. 3,4 Rapid and complete symptom relief has become the crucial goal of physicians to meet the desired effect amongst the majority of patients to improve quality of life. So, evolving therapeutic modalities continue to captivate the interest of clinicians and researchers.A high relapse rate has been a challenge to pursue long-term treatment. However, symptoms do not correlate well with the degree of reflux events or injury. This leads to the concept that GERD is a symptom-driven disease. Treatment strategies include continuous and discontinuous, that is, intermittent and on-demand. 5 Continuous maintenance is physician driven and aims to eliminate recurrent relapses. This modality is most useful in treating patients with severe forms of GERD who frequently suffer a relapse in a short time after effectively discontinuing the initial treatment. 6,7 Intermittent therapy is likewise physician driven, consisting of administration of short, predetermined courses of therapy usually lasting for 1-2 weeks when symptoms recur. Ondemand therapy is patient driven, characterized by patients taking medications when they feel it necessary, without fixed durations.Discontinuous therapy has been given attention primarily due to reduction of medication cost. More significantly, it may decrease the rebound in acid secretion seen after prolonged continuous therapy. 8 This strategy is convenient and allows patients to be in control. Candidates for intermittent or on-demand treatment are patients with mild erosive esophagitis and nonerosive reflux disease (NERD). Mild esophagitis patients (Los Angeles A and B) frequently have a longer relapse-free interval compared with severe esophagitis. 3 NERD comprises the majority of GERD patients (50-70%). 2,9,10 Although heterogeneous, NERD patients often improve with antisecretory medications particularly with proton pump inhibitors (PPI). 11 NERD patien...

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Review Article: Efficacy and safety of rabeprazole in treating gastroesophageal reflux disease

Cited by 6 publications

References 38 publications

Monitoring Cytochrome P-450 Activity During Rabeprazole Treatment in Patients with Gastresophageal Reflux Disease

Monitoring Cytochrome P-450 Activity During Rabeprazole Treatment in Patients with Gastresophageal Reflux Disease

Liquid chromatographic–mass spectrometry analysis and pharmacokinetic studies of a novel rabeprazole formulation, sterile powder for injection, in dogs and rats

The rising trend of on‐demand and intermittent proton pump inhibitor therapy in gastroesophageal reflux disease: What is the evidence?

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