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| |  DG DISPATCH - GASTRO 99: Pantoprazole Heals Erosive Esophagitis, Relieves Symptoms Of GERD By Cameron Johnston Special to DG News VANCOUVER, BC -- Sept. 2, 1999 -- People who develop erosive esophagitis as a result of gastro-esophageal reflux disease (GERD), or acid hypersecretion, seem to find more relief with pantoprazole (Pantoloc in Canada, Protonix, in the United States, Byk, Solvay, Wyeth-Ayerst) than they do with either Lilly’s Axid (nizatidine) or placebo. The findings were reported today at the Gastro '99 -the Pan-American Congress on Digestive Diseases. Pantoprazole is the most recent proton pump inhibitor to be launched for the treatment of GERD acid hypersecretion. In an analysis involving 846 patients with GERD and erosive esophagitis, patients were given either 10,20 or 40 mg of pantoprazole once daily, or placebo, or nizatidine (150 mg) twice daily. All three doses of pantoprazole were significantly more effective than either placebo or nizatidine in healing erosive esophagitis at the end of the four-week period, said Elaine Soffer, assistant director of clinical research or Wyeth-Ayerst, of Radnor, PA.. At the end of the four-week study, the healing rates were 42 percent, 57 percent and 78 percent for the 10, 20 and 40 mg doses, respectively. By comparison, the healing rate for nizatidine 150 mg twice daily was 21 percent and for placebo was 14 percent. Two-thirds of the patients enrolled in the study were suffering from Grade II erosions, as seen on endoscopy and one-quarter had Grade III erosions. By the end of the eighth week, the healing rates were 59 percent, 76 percent and 83 percent for the 10, 20 and 40 mg doses, respectively, Soffer said. The difference in healing rates between the 20 and 40 mg doses were very close she said, but it is expected that when the drug is approved for sale in the U.S. later this month, 40 mg dose will be the standard dose. The percentage of patients with complete resolution of daytime and night-time heartburn was significantly greater at most time points with all three doses of pantoprazole than with placebo or nizatidine, Soffer said in an interview. The fact that pantoprazole is so effective at relieving night-time heartburn is a significant development, she said, because other currently available PPIs are failing to provide adequate relief throughout the day. "Other PPIs start to wear off and the acid starts to creep back up," she said. She also noted that pantoprazole is a more specific acid suppressant and only begins to work when stomach acids exceed a certain level: pH less than 4. Side effects from the drugs were also lower in the pantoprazole group. According to Dr. David Armstrong, an assistant professor in the department of medicine, at McMaster University in Hamilton, GERD is a chronic condition and many patients with it could find themselves taking medications for indefinite periods of time and, therefore, it is important that they be able to tolerate the drug over the long term.
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