Clinical And Endoscopic Evaluation Of Gastroesophageal Reflux Disease In Patients Successfully Treated With Esomeprazole

Background - Esomeprazole, an S-isomer of omeprazole, is the first proton pump inhibitor developed as an optical isomer, and it has shown high healing rates in erosive esophagitis. Aim - To evaluate the efficacy and tolerability of esomeprazole in subjects with erosive esophagitis, according to the Los Angeles classification study design: an open, multi-center clinical study. Material and Methods - Two hundred and eighteen subjects with reflux esophagitis confirmed by endoscopy were included in an open, multi-center study in Brazil. All of them received esomeprazole 40 mg, once daily, for a 4-week period. Subjects who had unhealed esophagitis by week 4 continued the treatment for another 4 weeks. The primary efficacy endpoint was the healing rates by weeks 4 and 8. The secondary endpoints were the number of patients with symptom resolution by week 4, the number of days to sustained symptom resolution, number of symptom-free days and nights and safety and tolerability of the drug. Results - Healing rates by weeks 4 and 8 were 82% (confidence interval: 77.4%-87.6%) and 96.1% (confidence interval: 93.5%-98.8%), respectively. Ninety-nine (99%) of the patients had heartburn resolution by week 2. The most common adverse events were headache (4%), diarrhea (2.6%) and epigastric pain (2.2%). Conclusion - For the studied period, esomeprazole was shown to be a safe and well-tolerated drug, providing significant healing rates of mucosal breaks, regardless of LA classification, in patients with erosive esophagitis. Esomeprazole was also shown to be effective in quickly relieving symptoms.404262267Bardhan, K.D., Reflux rising - A burning issue! 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Clinical Study Of The Efficacy And Tolerability Of Lansoprazole In The Management Of Duodenal Ulcer [estudo Clinico Sobre A Eficacia E A Tolerabilidade De Lansoprazol No Tratamento Da Ulcera Duodenal]

The present study aimed to evaluate the efficacy and tolerability of lansoprazole 30 mg once daily in healing duodenal ulcer in two Brazilian centers. Patients were evaluated on the basis of clinical and endoscopic criteria before treatment and two weeks after the beginning of treatment. The patients who were not healed (red or white scar: S1 or S2 according Sakitas's classification) were reevaluated 4 weeks after the beginning of treatment. Fifthy-eight patients completed the study. Endoscopic examination revealed that duodenal ulcer was healed (S1 or S2 according Sakitas's classification) 2 weeks after the beginning of treatment in 51 patients (87,9%). In the remaining seven patients (12,1%) the ulcer was healed at the end of treatment (4 weeks). Clinical symptoms (daytime epigastric pain, nocturnal epigastric pain, daytime heartburn, nocturnal heartburn, nausea, vomiting, post-prandial distention, anorexia, and dysphagia) were dramatically reduced two weeks after the beginning of treatment in terms of the number of patients presenting the symptom and the severity. The present study confirms the efficacy of lansoprazole in the treatment of duodenal ulcer. All patients who completed the study were healed. The adverse events reported were mild nature and were not considered related to the medication under study, not requiring discontinuation of treatment. 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Essai thérapeutique multicentrique comparatif en double aveugle (1993) Gastroenterol Clin Biol, 17 (5), pp. 334-340Bader, J.P., Delchier, J.C., Clinical efficacy of pantoprazole compared with ranitidine (1994) Aliment Pharmacol Ther, 8 (1 SUPPL.), pp. 47-52Judmater, G., Koeltz, H.R., Comparison of pantoprazole and ranitidine in the treatment of acute duodenal ulcer (1994) Aliment Pharmacol Ther, 8 (1), pp. 81-86. , Pantoprazole-Duodenal Ulcer-Study GroupZaterka, S., Massuda, H., Chinzon, D., Treatment of duodenal ulcer with omeprazole or ranitidine in a Brazilian population: A multicenter double-blind, parallel group study (1993) Am J Gastroenterol, 88 (3), pp. 397-401Meneghelli, U.G., Zaterka, S., Castro, L.P., (1998) Pantoprazole Versus Ranitidine in the Treatment of Duodenal Ulcer. A Multicenter Study in Brazil, , Enviado para publica̧ãoMarks, I.N., Winter, T.A., Lucke, W., Omeprazole and ranitidine in duodenal ulcer healing (1988) S Afr Med J, 74 (SUPPL.), pp. 54-5