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| |  UEGW: Erosive Oesophagitis Treated Equally Effectively With Esomeprazole as Intravenous Injection, Infusion and Oral Medication By Adrian Burton MADRID, SPAIN -- November 7, 2003 -- Delivering esomeprazole 40 mg either as an injection or as an intravenous infusion is a good short-term alternative to oral administration. This was the finding presented November 4th by researchers from South Africa here at the 11th United European Gastroenterology Week. Esomeprazole 40 mg taken orally once a day leads to high rates of healing in erosive oesophagitis. "But there are several circumstance when a patient may not be able to swallow, for example in an acute situation like a gastric bleed …or perhaps when someone with a full stomach has had a [car] accident and is aspirating and you don't want to feed him," explained Herbert Schneider, MD, gastroenterologist, Milpark Hospital, Parktown, South Africa. "In these circumstances it would be safer to give the drug intravenously. [We wanted to know] the efficacy and safety of giving an intravenous infusion over 30 minutes [as compared to] an intravenous injection over 3 minutes." Two hundred and forty six patients with endoscopically confirmed erosive oesophagitis were randomised to receive either esomeprazole 40 mg via a 3-minute IV injection daily (n=79), a 30-minute IV infusion daily of the same (n=81), or an oral dose daily of the same (n=86) for one week -- the length of time one might reasonably need to use an extra-oral route in a hospital situation. All patients then received oral esomeprazole 40 mg once a day for 3 more weeks. The three groups were well matched at entry for grade of oesophagitis. Healing was determined by endoscopic examination. "Healing [was defined as] the complete healing of the mucosal breaks that had been seen at the start of the study," explained Dr. Schneider. "And there really was no significant difference between the groups." Healing rates were as follows: 79.7% of patients (95% CI 69.2%-88.0%) showed complete healing in the injection group; 80.2% of patients (95% CI 69.9%-88.3%) showed the same in the infusion group, and 82.6% of patients (95% CI 72.9%-89.9%) were completely healed in the oral group. No treatment-related adverse events were seen in any group. This study provides physicians with a range of alternatives for different clinical situations. "The message is that the intravenous form -- injection or infusion -- is as safe as the oral medication, and in terms of efficacy is the same as oral therapy. The infusion might be used for the patient who is going to spend a few days in hospital, while the injection could be used for patients with very severe oesophagitis who cannot swallow," concluded Dr. Schneider.
[Study Title: Esomeprazole 40 mg Provides Safe and Effective Healing of Erosive Esophagitis Whether Administered As An Intravenous (IV) Injection, An IV Infusion or Orally. Abstract Tue-G-033]
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