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| |  WCG: Nexium (Esomeprazole) Achieves Greater Healing, Higher Remission Rates than Prevacid (Lansoprazole) in GERD-Related Esophagitis BANGKOK, THAILAND -- February 28, 2002 -- The European METROPOLE study, presented today at the World Congress of Gastroenterology in Bangkok, Thailand, revealed that Nexium (esomeprazole) achieves significantly (p<0.0001) higher remission rates than Prevacid (lansoprazole) during six months maintenance therapy in patients with healed esophagitis (1) related to gastroesophageal reflux disease (GERD). Physicians agree that healing of esophageal lesions in patients with erosive GERD should be followed by measures to prevent reoccurrence. Without maintenance therapy, 60 - 90 percent of erosive GERD patients relapse within just six months of initial healing (2). Last October, Nexium was also shown to provide significantly (p<0.0001) greater esophageal healing than lansoprazole, in the large EAZEE study, presented at the United European Gastroenterology Week (3). "With Nexium, physicians can be confident that over 90 percent of patients with esophagitis will heal within one treatment period and over 80 percent will remain in remission -- these are the highest figures we've seen for a PPI [proton pump inhibitor]," emphasises Professor Karsten Lauritsen, study coordinating investigator, Odense University Hospital, Denmark. METROPOLE, a large, multi-centre maintenance study demonstrated that Nexium consistently maintains more patients in remission than lansoprazole, regardless of the severity of the initial esophageal damage. In contrast, the efficacy of lansoprazole declines to a greater degree with increasing severity of initial damage. The same trend was also found when comparing the efficacy of Nexium and lansoprazole to heal esophagitis. Regardless of disease severity, Nexium is more effective than lansoprazole for initial healing and maintaining patients with esophagitis in remission (2,3). This is of particular relevance to primary care physicians, who frequently provide therapy to patients with esophagitis prior to a diagnostic endoscopy. As symptom severity gives little indication of esophageal damage physicians cannot determine which patients are more likely to suffer healing difficulties or relapse without diagnostic endoscopy. Of great importance to patients, Nexium was highly effective in preventing the return of reflux symptoms 2. Significantly fewer patients receiving Nexium experienced any of the symptoms of GERD -- heartburn, acid regurgitation and epigastric pain -- than those being maintained on lansoprazole at the end of six months of treatment. Patient satisfaction was a crucial element of the trial, as patients who experienced frequent symptoms, and were unwilling to continue in the study, were counted as relapsed patients, regardless of the presence or absence of new esophageal erosions. A model of the complete clinical management of reflux esophagitis, based on the results of both studies, EAZEE and METROPOLE, illustrates that 77 percent of patients who receive acute (40 mg once daily) and maintenance (20 mg once daily) therapy with Nexium are successfully in remission six months later, compared with 66 percent of patients receiving lansoprazole (30mg once daily, then 15 mg once daily) (4). Among patients with more severe initial damage (LA grades C or D), the difference between the two drugs is even greater; 65 percent of Nexium patients are in remission after six months compared with 43 percent of patients receiving lansoprazole. An estimated 15 million Europeans with GERD experience esophageal damage (5). For each one hundred patients with reflux esophagitis, who are initially treated with Nexium 40mg once daily and then maintained on Nexium 20mg once daily, an additional 11 patients will be successfully healed and will remain in remission, than if treated by lansoprazole. References: (1) Lauritsen K, Junghard O, Eklund S. Esomeprazole 20 mg compared with lansoprazole 15 mg for maintenance therapy in patients with healed reflux esophagitis. Presented at the World Congress of Gastroenterology, Bangkok, 24 February - 1 March 2002. (2) Sontag S. Rolling review: gastroesophageal reflux disease. Alimentary Pharmacology and Therapeutics. 1993; 7(3): 293 - 312. (3) Castell D, Kahrilas P, Richter J. Esomeprazole provides more effective healing than lansoprazole in GERD patients with reflux esophagitis. Presented at the United European Gastroenterology Week, Amsterdam, 6-10 October 2001. (4) Lind T, Junghard O, Lauritsen K. Esomeprazole and lansoprazole in the management of patients with reflux esophagitis (RE): combining results from two clinical studies. Presented at the World Congress of Gastroenterology, Bangkok, 24 February - 1 March 2002. (5) Nebel O, Fornes M, Castell D. Symptomatic gastroesophageal reflux: incidence and precipitating factors. American Journal of Digestive Diseases, 1976; 21(11): 953-6.
SOURCE: CPR Worldwide
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