The role of acid suppression in patients with endoscopy‐negative reflux disease: the effect of treatment with esomeprazole or omeprazole

Armstrong, David; Talley, Nicholas J.; Lauritsen, K; Moum, Bjørn; Lind, Tore; H, Tunturi-Hihnala; Venables, T. L.; Green, J.; Bigard, Marc‐André; Mössner, Joachim; Junghard, Ola

doi:10.1111/j.1365-2036.2004.02085.x

Cited by 91 publications

(79 citation statements)

References 40 publications

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“…However, two randomised controlled trials have shown that omeprazole 20 mg daily was comparable to esomeprazole 20 mg daily in the treatment of non-erosive and erosive GERD. 16,28 The CYP2C19 metabolizer status has been shown to affect intragastric acid suppression by PPIs, as well as the clinical efficacy of PPIs in the treatment of GERD and in H. pylori eradication therapy. 24 In particular, the RM status has been identified as significant risk factor for treatment failure in Asian patient populations.…”

Section: Discussionmentioning

confidence: 99%

“…8 This functional superiority of esomeprazole is mirrored by significant clinical advantages over some other PPIs in healing and maintenance therapy of erosive GERD 9-15 whereas there were no differences when omeprazole was used in the treatment of non-erosive GERD. 16 Generic omeprazole has been approved and is being increasingly used for the treatment of GERD and other acid-related gastrointestinal disorders. However, clinical or intragastric pH studies comparing generic omeprazole with other original PPIs are sparse.…”

Section: Discussionmentioning

confidence: 99%

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Intragastric acidity during administration of generic omeprazole or esomeprazole - a randomised, two-way crossover study including CYP2C19 genotyping

Miehlke¹,

Löbe

Madisch³

et al. 2010

Alimentary Pharmacology &Amp; Therapeutics

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Intragastric acidity during administration of generic omeprazole or esomeprazole - a randomised, two-way crossover study including CYP2C19 genotyping

Miehlke¹,

Löbe

Madisch³

et al. 2010

Alimentary Pharmacology &Amp; Therapeutics

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“…For example, extensive head-to-head clinical trials have been carried out between Nexium (esomeprazol)-AstraZeneca's ulcer and heartburn drug of proton pump inhibitor type-and other proton pump inhibitors. For some uses Nexium is shown to be better (Castell et al 2002;Kahrilas et al, 2001;Labenz et al, 2003;Richter et al 2001), whereas for other uses it is not (Armstrong, 2004). It has been a clear advantage to…”

Section: Introductionmentioning

confidence: 98%

Incentives for clinical trials

Grönqvist

Lundin²

2009

Economics of Innovation and New Technology

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Who gains from more information on the quality of pharmaceutical drugs?Are there incentives for voluntary post-approval clinical trials among pharmaceutical companies? Contrary to popular belief, this paper shows that it is not in the consumer interest that clinical evidence establishing the relative e¤ectiveness within a class of drugs are produced. Pharmaceutical companies, on the other hand, do bene…t: the elimination of uncertainty regarding quality increases expected product di¤erentiation, thereby raising prices for both high-quality and low-quality drugs, to the disadvantage of consumers.Still there is no unique equilibrium where the market provides clinical trials.If the costs of carrying out clinical trials are small, in relative terms, there will be a coordination problem between …rms, as …rms will want a rival …rm to carry the cost. If the costs are large they will be prohibitive. Legislation that obligates entering …rms to carry out post-approval trials is bene…cial for …rms if it solves the coordination problem, but is otherwise harmful. Legislation is never in the interest of consumers.

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“…Failure to control intragastric pH, especially during sleep, is related to a low rate of symptomatic response in patients with extraesophageal manifestations (48). The failure mechanisms are poor treatment adherence, weakly acidic reflux (pH 4-7), visceral hypersensitivity (functional heartburn), duodenogastric reflux, delayed gastric emptying, eosinophilic esophagitis, and comorbidity (56).…”

Section: Clinical Evidencementioning

confidence: 99%

“…Table IV shows the percentages of intragastric pH control in different clinical trials (56,57). PPIs are more efficacious than placebo in erosive esophagitis -55.…”

Section: Clinical Evidencementioning

confidence: 99%

Proton pump inhibitors in gastroesophageal reflux disease: a custom-tailored therapeutic regimen

Sobrino-Cossío

López-Alvarenga

Remes-Troche

et al. 2012

Rev. esp. enferm. dig.

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The Montreal Definition and Classification divides Gastroesophageal Reflux Disease (GERD) into esophageal symptomatic syndromes (and with mucosal damage) and extraesophageal syndromes (with acid established association and proposed association). In typical GERD symptoms, an 8-week treatment with PPIs is satisfactory in most cases (> 90%). Response rates to PPIs in GERD are highly variable, as they also rely on an appropriate clinical diagnosis of the disease; endoscopy differentiates the macroscopic GERD phenotype. The non-erosive variety (50-70% prevalence) has a different symptomatic response rate, as gastric acid is not the sole etiology of symptoms. The possible explanations of treatment failure include treatment adherence, PPI metabolism alterations and characteristics, and inadequate diagnosis. Refractory symptoms are related to gastric content neutralization by the chronic use of PPIs.Extraesophageal manifestations are associated with other pathophysiological mechanisms where an autonomic nervous system disturbance gives rise to symptoms. In these clinical entities, the relationship between symptoms and acid needs to be established in order to determine the use of PPIs, or consider other drugs. In other words, so as to "custom-tailor the best-fitting therapy" we need to answer the questions for whom, for what, how and for how long. Finally, PPI safety and tolerability are factors to be considered in elderly patients requiring chronic PPI use, who usually have chronic concomitant illnesses.

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The role of acid suppression in patients with endoscopy‐negative reflux disease: the effect of treatment with esomeprazole or omeprazole

Cited by 91 publications

References 40 publications

Intragastric acidity during administration of generic omeprazole or esomeprazole - a randomised, two-way crossover study including CYP2C19 genotyping

Intragastric acidity during administration of generic omeprazole or esomeprazole - a randomised, two-way crossover study including CYP2C19 genotyping

Incentives for clinical trials

Proton pump inhibitors in gastroesophageal reflux disease: a custom-tailored therapeutic regimen

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