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| |  Once daily Esomeprazole Better Than Lansoprazole for Intragastric Acid Control in Patients Who Have Barrett's Esophagus: Presented at ACG By Danny Kucharsky PHILADELPHIA, PA -- October 19, 2007 -- Oral esomeprazole 40 mg once or twice daily provides greater control of intragastric acid at steady state than oral lansoprazole 30 mg once or twice daily in patients with Barrett's esophagus, finds a study presented here at the annual scientific meeting of the American College of Gastroenterology (ACG). "Esomeprazole has previously been shown to control intragastric acidity in patients with Barrett's esophagus," said investigator Stuart Spechler, MD, Chair in Gastroenterology, Professor, Internal Medicine, Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas, Texas, United States. However, he added, to date, no comparative studies have been conducted with other proton pump inhibitors. The study compared the efficacy of once-daily doses of esomeprazole and lansoprazole for the control of intragastric pH in patients with Barrett's esophagus. The multicentre, randomised, open-label crossover study included adults who were Helicocobacter pylori-negative and had a history of Barrett's esophagus within the past 2 years, without evidence of high-grade dysplasia or adenocarcinoma. Patients were assigned randomly to esomeprazole 40 mg once daily for 15 days followed by esomeprazole 40 mg twice for 10 days or lansoprazole 30 mg once daily for 15 days followed by lansoprazole 30 mg twice daily for 10 days. Of 113 patients who were randomised, 46 were eligible for the analysis of once-daily dosing, and 41 were eligible for the analysis of twice-daily dosing. To be included in the primary analysis patients had to complete both comparative treatment sequences, have valid pH data and have no major protocol violations or deviations. Results of the analysis show that with both the once- and twice-daily dosing regimens, intragastric pH was >=4.0 for significantly longer during a 24-hour monitoring period with esomeprazole than lansoprazole (P <.0001). The proportion of patients whose intragastric pH was >=4.0 for more than 12 hours was also significantly greater for esomeprazole than lansoprazole during both once- daily dosing in the 46 patients evaluated (87.0% vs 52.2%, respectively; P =.0004) and twice- daily dosing in the 41 evaluated (97.6% vs 80.5%, respectively; P =.016). Funding for this study was provided by AstraZeneca.
[Presentation title: Intragastric Acid Control in Patients Who Have Barrett's Esophagus: Comparison of Once-and Twice-Daily Regimens of Esomeprazole and Lansoprazole. Abstract 687]
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