PMID- 18479175
OWN - NLM
STAT- MEDLINE
DCOM- 20081014
LR  - 20211020
IS  - 1173-2563 (Print)
IS  - 1173-2563 (Linking)
VI  - 28
IP  - 6
DP  - 2008
TI  - Effect of increasing esomeprazole and pantoprazole doses on acid control in 
      patients with symptoms of gastro-oesophageal reflux disease: a randomized, 
      dose-response study.
PG  - 333-43
AB  - BACKGROUND AND OBJECTIVE: In patients with gastro-oesophageal reflux disease 
      (GORD), dose escalation or drug switching may be considered in those with 
      symptoms that persist despite standard-dose proton pump inhibitor (PPI) therapy. 
      This study set out to assess whether increasing the dosage of oral esomeprazole 
      and pantoprazole improves acid control in GORD patients, and to compare the 
      pharmacodynamic efficacy of esomeprazole and pantoprazole administered at 
      different dosages. METHODS: This was an open-label, randomized, six-way crossover 
      study that included Helicobacter pylori-negative GORD patients (aged 20-60 years) 
      with <30% of time with intragastric pH>4. Patients were treated with oral 
      once-daily esomeprazole 20 mg, 40 mg and 80 mg, and pantoprazole 20 mg, 40 mg and 
      80 mg, for 5 days. The main outcome measures were time with intragastric pH>4 
      over 24 hours, median pH over 24 hours and area under the hydrogen ion versus 
      time curve on day 5 for each treatment period. RESULTS: Dose escalation with both 
      PPIs improved acid control. The proportion of time with intragastric pH>4 (day 5) 
      was 46.7% with esomeprazole 20 mg/day, 58.6% with esomeprazole 40 mg/day, and 
      65.8% with esomeprazole 80 mg/day; the corresponding percentages with 
      pantoprazole were 28.6%, 36.9% and 44.9%, respectively. On a 
      milligram-per-milligram basis, esomeprazole provided greater acid control than 
      pantoprazole (p<0.001). CONCLUSION: Dose escalation with oral esomeprazole and 
      pantoprazole improves acid control in patients with GORD, although esomeprazole 
      provides significantly greater acid control on a milligram-per-milligram basis.
FAU - Wilder-Smith, Clive
AU  - Wilder-Smith C
AD  - Brain-Gut Research Group, Gastroenterology Group Practice, Berne, Switzerland. 
      cws@ggp.ch
FAU - Backlund, Anna
AU  - Backlund A
FAU - Eckerwall, Goran
AU  - Eckerwall G
FAU - Lind, Tore
AU  - Lind T
FAU - Fjellman, Mia
AU  - Fjellman M
FAU - Rohss, Kerstin
AU  - Rohss K
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - New Zealand
TA  - Clin Drug Investig
JT  - Clinical drug investigation
JID - 9504817
RN  - 0 (2-Pyridinylmethylsulfinylbenzimidazoles)
RN  - 0 (Anti-Ulcer Agents)
RN  - D8TST4O562 (Pantoprazole)
RN  - N3PA6559FT (Esomeprazole)
SB  - IM
MH  - 2-Pyridinylmethylsulfinylbenzimidazoles/*therapeutic use
MH  - Adult
MH  - Anti-Ulcer Agents/*therapeutic use
MH  - Cross-Over Studies
MH  - Dose-Response Relationship, Drug
MH  - Esomeprazole/*therapeutic use
MH  - Female
MH  - Gastric Acidity Determination
MH  - Gastroesophageal Reflux/*drug therapy/metabolism
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pantoprazole
EDAT- 2008/05/16 09:00
MHDA- 2008/10/15 09:00
CRDT- 2008/05/16 09:00
PHST- 2008/05/16 09:00 [pubmed]
PHST- 2008/10/15 09:00 [medline]
PHST- 2008/05/16 09:00 [entrez]
AID - 2861 [pii]
AID - 10.2165/00044011-200828060-00001 [doi]
PST - ppublish
SO  - Clin Drug Investig. 2008;28(6):333-43. doi: 10.2165/00044011-200828060-00001.