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| |  DG DISPATCH - WCPGHN: Flavoured Lansoprazole Increases Compliance For Children With Gastroesophageal Reflux By Maria Bishop Special to DG News
BOSTON, MA -- August 9, 2000 -- Pediatric gastroesophageal reflux disease (GERD) can be difficult to treat. This is in no small part due to the fact that treatment involving proton-pump inhibitors (PPI) is likely to result in suboptimal dosing, as children under seven years of age generally have difficulty swallowing capsules. A retrospective evaluative study from the U.S., led by Jeffrey O. Phillips, PharmD, BCPS, examined 40 children seen in two centres who received the same formulation of flavoured lansoprazole suspension for the treatment of GERD, attempting to overcome the limitation of suboptimal dosing. Results of this study were presented at the first World Congress of Pediatric Gastroenterology, Hepatology and Nutrition in Boston, MA, prior to completion of a prospective, comparative, clinical trial, which is now being conducted. Dr. Phillips, assistant professor of surgery and surgical practical care chief, department of surgery, Health Sciences Center, University of Missouri-Columbia, Columbia, MO, noted that "it was previously thought that PPIs could not be formulated into true suspensions because of their inherent lability to acid." A flavoured suspension of the drug was able to be created, however, and was offered to patients who had failed prior treatment strategies and been referred from primary-care physicians. The majority of patients responded favourably, with good symptom control, to the flavoured lansoprazole suspension given once or twice daily in doses of 1.5 to 3 mg/kg/day. Additionally, this formulation was well tolerated, with no reported attributable adverse effects. Duration of treatment exceeded six months in many of the patients with continued response. Most patients had significant symptom relief within one to two weeks after starting the treatment. This study supports the findings of a previous study using the same formulation of flavoured PPI suspension in children referred to a university-based otolaryngology clinic. Many studies have shown PPIs to be highly effective and safe in adults with GERD where a defined dosage is available. An optimal regimen for pediatric GERD consists of an antisecretory agent in a palatable, titratable dosage form that can be used with or without complementary therapies (such as prokinetic agents). Pediatric GERD goes unrecognized by many health practitioners because of the difficulty in making a diagnosis. Symptoms of pediatric GERD include vomiting and general irritability.
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