학술논문

Randomised clinical trial: a novel rabeprazole extended release 50 mg formulation vs. esomeprazole 40 mg in healing of moderate-to-severe erosive oesophagitis - the results of two double-blind studies.
Document Type
Article
Source
Alimentary Pharmacology & Therapeutics. Jan2011, Vol. 33 Issue 2, p203-212. 10p. 1 Diagram, 3 Charts, 1 Graph.
Subject
*CLINICAL trials
*ESOMEPRAZOLE
*HEARTBURN
*GASTROESOPHAGEAL reflux
*DISEASES
Language
ISSN
0269-2813
Abstract
Background Current PPIs may not achieve desired outcomes in some GERD patients due to limited duration of acid inhibition. Aim To evaluate a novel rabeprazole extended release (ER), which provides longer duration of drug exposure and acid suppression, in healing and symptomatic resolution of moderate-severe erosive oesophagitis. Methods Patients with LA grade C or D oesophagitis were randomised to rabeprazole- ER 50 mg or esomeprazole 40 mg once daily in two identical 8-week double-blind trials (N = 2130). Two primary endpoints were tested sequentially: (1) healing by 8 weeks [hypothesis: rabeprazole-ER non-inferior to esomeprazole (non-inferiority margin = 8%)], (2) healing by 4 weeks [hypothesis: rabeprazole-ER superior to esomeprazole (P < 0.05)]. The secondary endpoint was sustained heartburn resolution at 4 weeks. Results Rabeprazole-ER was non-inferior to esomeprazole in week-8 healing (80.0% vs. 75.0%; 77.5% vs. 78.4%). Week-4 healing (54.8% vs. 50.3%; 50.9% vs. 50.7%) and sustained heartburn resolution (48.3% vs. 48.2%; 53.2% vs. 52.5%) were not significantly different. Post hoc combined results for grade D revealed rabeprazole-ER vs. esomeprazole differences in week-8 healing = 10.4% (95% CI: )1.4%, 22.2%) and week-4 healing = 12.0% (P = 0.048). Conclusions Rabeprazole-ER is as effective as esomeprazole in healing moderatesevere oesophagitis and achieves similar rates of heartburn resolution. Subgroup analysis suggests the possibility of benefit in severe oesophagitis, but this requires further evaluation (ClinicalTrials.gov: NCT00658528 and NCT00658775). [ABSTRACT FROM AUTHOR]