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| |  Rabeprazole More Effective Than Omeprazole Against Erosive Heartburn in Overweight and Obese Patients: Presented at ACG By Danny Kucharsky PHILADELPHIA, PA -- October 17, 2007 -- Rabeprazole may be more effective than omeprazole for the treatment of heartburn symptoms in overweight or obese patients within the first week of initiating therapy, according to a study presented here at the American College of Gastroenterology (ACG) 2007 Annual Scientific Meeting. The results of a post hoc subgroup analysis of the multi-centre randomised Italian Rabeprazole Study Group trial were presented on October 15 by Brian Jacobson, MD, MPH, Director of Endoscopic Ultrasonography and Associate Director of Endoscopy Services, Boston Medical Center, and Assistant Professor of Medicine, Boston University Medical Center, Boston, Massachusetts, United States. "We know that heartburn symptoms and complications of reflux increase in prevalence as you get heavier," Dr. Jacobson said. "Is there a difference in response to the proton pump inhibitors based on your body mass index?" Patients enrolled in the trial had a history of at least 3 months of erosive oesophagitis-like symptoms. They received once-daily rabeprazole 20 mg or omeprazole 20 mg for 4 weeks. Those with persistent erosive oesophagitis or gastroesophageal reflux disease (GERD) symptoms received an additional 4 weeks of treatment. Patients were classified as lean (< 25 kg/ mē) and overweight or obese (>= 25 kg/mē). Overall there were more patients in the BMI >= 25 kg/mē (rabeprazole, n = 152; omeprazole, n = 163) versus the < 25 kg/ mē group (rabeprazole, n = 93; omeprazole, n = 80). At 4 or 8 weeks, there was no difference between treatment groups within each BMI category in the percentage of healing from erosive oesophagitis. "That, I think, proves that regardless of the drug you take, regardless of your body mass index, these drugs are very good," Dr. Jacobson said. In the overweight or obese patients, the mean time for patients to achieve first day of satisfactory heartburn relief in the rabeprazole group was significantly shorter compared with omeprazole (2.6 days versus 3.8 days, respectively; P =.0113). In the lean patients, the mean time to achieve first day of satisfactory heartburn relief showed a numerical trend in favour of rabeprazole compared with omeprazole but did not reach statistical significance (3.1 days versus 5.0 days, respectively; P =.1996). Among the overweight or obese patients there was "a significantly higher chance of having a lot more symptom relief quicker -- within the first few days -- using rabeprazole versus omeprazole," Dr. Jacobson said. "It raises questions: Is there something different we should be doing based on body mass index? Is there a clinically meaningful difference?" Dr. Jacobson concluded that there are no answers to those questions at present. "Currently, nobody is looking at changing the dosing timetable of the proton pump inhibitor based on weight," he said. "The drugs do what they're supposed to do and they do it well pretty much regardless of [a person's] size." The study was supported by Eisai, Ortho-McNeil Janssen and Janssen-Cilag.
[Presentation title: PPI Efficacy in Overweight/Obese Patients With Erosive GERD; Rabeprazole(RAB) 20 mg vs. Omeprazole (OME) 20 mg. Abstract 348]
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