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Comparison of four proton pump inhibitors for the short-term treatment of esophagitis in elderly patients.
- Source :
-
World journal of gastroenterology [World J Gastroenterol] 2007 Sep 07; Vol. 13 (33), pp. 4467-72. - Publication Year :
- 2007
-
Abstract
- Aim: To compare efficacy and tolerability of four proton pump inhibitors (PPIs) commonly used in the short-term therapy of esophagitis in elderly patients.<br />Methods: A total of 320 patients over 65 years with endoscopically diagnosed esophagitis were randomly assigned to one of the following treatments for 8 wk: (1) omeprazole 20 mg/d; (2) lansoprazole 30 mg/d; (3) pantoprazole 40 mg/d, or (4) rabeprazole 20 mg/d. Major symptoms, compliance, and adverse events were recorded. After 8 wk, endoscopy and clinical evaluation were repeated.<br />Results: Per protocol and intention to treat healing rates of esophagitis were: omeprazole = 81.0% and 75.0%, lansoprazole = 90.7% (P = 0.143 vs omeprazole) and 85.0%, pantoprazole = 93.5% (P = 0.04 vs omeprazole) and 90.0% (P = 0.02 vs omeprazole), rabeprazole = 94.6% (P = 0.02 vs omeprazole) and 88.8% (P = 0.04 vs omeprazole). Dividing patients according to the grades of esophagitis, omeprazole was significantly less effective than the three other PPIs in healing grade 1 esophagitis (healing rates: 81.8% vs 100%, 100% and 100%, respectively, P = 0.012). Pantoprazole and rabeprazole (100%) were more effective vs omeprazole (89.6%, P = 0.0001) and lansoprazole (82.4%, P = 0.0001) in decreasing heartburn. Pantoprazole and rabeprazole (92.2% and 90.1%, respectively) were also more effective vs lansoprazole (75.0%, P < 0.05) in decreasing acid regurgitation. Finally, pantoprazole and rabeprazole (95.2% and 100%) were also more effective vs lansoprazole (82.6%, P < 0.05) in decreasing epigastric pain.<br />Conclusion: In elderly patients, pantoprazole and rabeprazole were significantly more effective than omeprazole in healing esophagitis and than omeprazole or lansoprazole in improving symptoms. H pylori infection did not influence the healing rates of esophagitis after a short-term treatment with PPI.
- Subjects :
- Aged
Aged, 80 and over
Endoscopy, Gastrointestinal
Esophagitis diagnosis
Esophagitis pathology
Female
Humans
Lansoprazole
Male
Pantoprazole
Rabeprazole
Treatment Outcome
2-Pyridinylmethylsulfinylbenzimidazoles therapeutic use
Anti-Ulcer Agents therapeutic use
Esophagitis drug therapy
Omeprazole therapeutic use
Proton Pump Inhibitors therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1007-9327
- Volume :
- 13
- Issue :
- 33
- Database :
- MEDLINE
- Journal :
- World journal of gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 17724802
- Full Text :
- https://doi.org/10.3748/wjg.v13.i33.4467