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| |  DG DISPATCH - ACG: Esomeprazole Provides Impressive Acid Control By Jill Stein Special to DG News
NEW YORK, NY -- October 17, 2000 -- New findings suggest that esomeprazole (Nexium) 40 mg provides more effective acid control than omeprazole (Prilosec) 40 mg. Esomeprazole is a new proton pump inhibitor and the S-isomer of omeprazole. The findings were presented at the 65th Annual Scientific Meeting of the American College of Gastroenterology in New York City. K. Rohss, of AstraZeneca research and development in Molndal, Sweden, and associates compared the effects of single-and repeated-dose administrations of esomeprazole 40 mg and double the standard dose of omeprazole (i.e., 40 mg) on intragastric pH levels in patients with symptoms of gastroesophageal reflux disease (GERD). "Healing of esophagitis is directly related to the time with intragastric pH greater than 4 over the 24-hour period," Rohss said. In patients with symptoms of GERD, esomeprazole 20 mg and 40 mg has been shown to achieve greater and more sustained acid control than omeprazole 20 mg, with a similar tolerability and safety profile. Against this background, 130 Helicobacter pylori-negative patients with symptoms of GERD were assigned to receive oral esomeprazole 40 mg or omeprazole 40 mg once daily for five days, with a washout period of at least 14 days between treatments. Continuous 24-hour intragastric pH recording was performed under standardized conditions on days one and five of each treatment period. Overall, 120 patients completed the study. Results showed that the percentage of time during which intragastric pH was greater than 4 and greater than 3 was significantly higher with esomeprazole 40 mg than with omeprazole 40 mg on both day 1 and day 5. The mean value of the 24-hour median intragastric pH was significantly higher with esomeprazole 40 mg than with omeprazole 40 mg on days 1 and 5. The percentage of patients with intragastric pH greater than 4 for at least 12 hours was significantly higher in the esomeprazole 40 mg group compared to the omeprazole 40 mg group on days 1 and 5. The percentage of patients with intragastric pH greater than 4 for at least 16 hours was also significantly higher in the esomeprazole 40 mg group on day 5. Repeated dose administration of esomeprazole 40 mg and omeprazole 40 mg was well tolerated, with a similar rate of adverse events in the two treatment groups. Overall, the results show that esomeprazole 40 mg provides significantly better acid control than double the standard dose of omeprazole after both single and repeated dose administration, Rohss said.
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