Efficacy and cost effectiveness of lansoprazole versus omeprazole in maintenance treatment of symptomatic gastroesophageal reflux disease

Objective: To determine the dosing equivalents and cost effectiveness of lansoprazole versus omeprazole in maintenance therapy of gastroesophageal reflux disease (GERD). Study Design: Single-blind, randomized, crossover study. Patients and Methods: After completing a 1-week washout period, 27 outpatients (mean age, 66 years) with documented GERD were randomly assigned to receive omeprazole 20 mg or lansoprazole 15 mg daily for 2 weeks. The dosages were then increased to omeprazole 40 mg or lansoprazole 30 mg daily for an additional 2 weeks. All patients completed a second 1-week washout period before crossing over to the alternate agent. Patients recorded GERD-related symptoms (heartburn, chest pain, and regurgitation) daily in a diary. The total symptom score (the sum of the 3 individual symptom scores) were compared for all treatments. Cost effectiveness was evaluated by determining the cost per percent reduction in the total symptom score. Results: All treatment groups had significant reductions from baseline in the total symptom score (P \u3c 0.01), No significant difference was seen between lansoprazole 15-mg and omeprazole 20-mg groups or the the lansoprazole 30-mg and omeprazole 40-mg groups. Lansoprazole 15 mg was found to be as effective as omeprazole 40 mg and omeprazole 20 mg was as effective as lansoprazole 30 mg. The average cost per percent reduction in total symptom score was $0.03 for the lansoprazole 15-mg, lansoprazole 30-mg, and omeprazole 20-mg doses and$0.05 for the omeprazole 40-mg dose. Conclusion: Lansoprazole is as effective as omeprazole in providing symptomatic relief of GERD, Based on acquisition cost, lansoprazole is more cost effective than omeprazole

Efficacy and cost effectiveness of lansoprazole versus omeprazole in maintenance treatment of symptomatic gastroesophageal reflux disease

Objective: To determine the dosing equivalents and cost effectiveness of lansoprazole versus omeprazole in maintenance therapy of gastroesophageal reflux disease (GERD). Study Design: Single-blind, randomized, crossover study. Patients and Methods: After completing a 1-week washout period, 27 outpatients (mean age, 66 years) with documented GERD were randomly assigned to receive omeprazole 20 mg or lansoprazole 15 mg daily for 2 weeks. The dosages were then increased to omeprazole 40 mg or lansoprazole 30 mg daily for an additional 2 weeks. All patients completed a second 1-week washout period before crossing over to the alternate agent. Patients recorded GERD-related symptoms (heartburn, chest pain, and regurgitation) daily in a diary. The total symptom score (the sum of the 3 individual symptom scores) were compared for all treatments. Cost effectiveness was evaluated by determining the cost per percent reduction in the total symptom score. Results: All treatment groups had significant reductions from baseline in the total symptom score (P \u3c 0.01), No significant difference was seen between lansoprazole 15-mg and omeprazole 20-mg groups or the the lansoprazole 30-mg and omeprazole 40-mg groups. Lansoprazole 15 mg was found to be as effective as omeprazole 40 mg and omeprazole 20 mg was as effective as lansoprazole 30 mg. The average cost per percent reduction in total symptom score was $0.03 for the lansoprazole 15-mg, lansoprazole 30-mg, and omeprazole 20-mg doses and$0.05 for the omeprazole 40-mg dose. Conclusion: Lansoprazole is as effective as omeprazole in providing symptomatic relief of GERD, Based on acquisition cost, lansoprazole is more cost effective than omeprazole

Efficacy and cost effectiveness of lansoprazole versus omeprazole in maintenance treatment of symptomatic gastroesophageal reflux disease

Objective: To determine the dosing equivalents and cost effectiveness of lansoprazole versus omeprazole in maintenance therapy of gastroesophageal reflux disease (GERD). Study Design: Single-blind, randomized, crossover study. Patients and Methods: After completing a 1-week washout period, 27 outpatients (mean age, 66 years) with documented GERD were randomly assigned to receive omeprazole 20 mg or lansoprazole 15 mg daily for 2 weeks. The dosages were then increased to omeprazole 40 mg or lansoprazole 30 mg daily for an additional 2 weeks. All patients completed a second 1-week washout period before crossing over to the alternate agent. Patients recorded GERD-related symptoms (heartburn, chest pain, and regurgitation) daily in a diary. The total symptom score (the sum of the 3 individual symptom scores) were compared for all treatments. Cost effectiveness was evaluated by determining the cost per percent reduction in the total symptom score. Results: All treatment groups had significant reductions from baseline in the total symptom score (P \u3c 0.01), No significant difference was seen between lansoprazole 15-mg and omeprazole 20-mg groups or the the lansoprazole 30-mg and omeprazole 40-mg groups. Lansoprazole 15 mg was found to be as effective as omeprazole 40 mg and omeprazole 20 mg was as effective as lansoprazole 30 mg. The average cost per percent reduction in total symptom score was $0.03 for the lansoprazole 15-mg, lansoprazole 30-mg, and omeprazole 20-mg doses and$0.05 for the omeprazole 40-mg dose. Conclusion: Lansoprazole is as effective as omeprazole in providing symptomatic relief of GERD, Based on acquisition cost, lansoprazole is more cost effective than omeprazole

Total body skin examination for skin cancer screening in patients with focused symptoms

Dermatology-oncolog

Total body skin examination for skin cancer screening in patients with focused symptoms

PubMed ID: 21757257Background: The value of total body skin examination (TBSE) for skin cancer screening is controversial. Objective: We sought to determine whether TBSE could be helpful in patients with focused skin symptoms who would not otherwise have undergone TBSE. Methods: In a prospective, multicenter, cross-sectional study consecutive adult patients were recruited during a period of 18 months. Physicians first inspected problem areas and uncovered areas and then performed TBSE. Equivocal lesions detected in both steps were excised or biopsied. Primary outcomes were the absolute and relative risks of missing skin cancer and the number of patients needed to examine to detect melanoma or another malignancy. A secondary outcome was the proportion of false-positive results obtained by TBSE. Results: We examined 14,381 patients and detected 40 (0.3%) patients with melanoma and 299 (2.1%) with at least one nonmelanoma skin cancer by TBSE. In 195 (1.3%) patients equivocal lesions found by TBSE turned out to be benign. We calculated that 47 patients need to be examined by TBSE to find one skin malignancy and 400 patients to detect one melanoma. The risk of missing one malignancy if not performing TBSE was 2.17% (95% confidence interval 1.25-3.74). Factors significantly increasing the chance to find a skin cancer were age, male gender, previous nonmelanoma skin cancer, fair skin type, skin tumor as the reason for consultation, and presence of an equivocal lesion on problem/uncovered areas. Limitations: The impact of TBSE on skin cancer mortality was not evaluated. Conclusions: TBSE improves skin cancer detection in patients with focused skin symptoms and shows a low rate of false-positive results. © 2010 by the American Academy of Dermatology, Inc