Treatment of patients with persistent heartburn symptoms: a double-blind, randomized trial.

Abstract

BACKGROUND & AIMS:

Common treatment practices in patients who continue to be symptomatic on proton pump inhibitor once-daily treatment include either increasing the dosage or the use of supplemental medication. This trial's purpose was to compare 2 therapeutic strategies, increasing the proton pump inhibitor dosage to twice daily versus switching to another proton pump inhibitor, in patients with persistent heartburn while receiving standard-dose proton pump inhibitor therapy.

METHODS:

This multicenter, randomized, double-blind, double-dummy trial included patients with persistent heartburn symptoms while receiving therapy with lansoprazole 30 mg once daily. Patients were randomly assigned to treatment for 8 weeks with either single-dose esomeprazole (40 mg once daily) (n = 138) or lansoprazole 30 mg twice daily (n = 144). The primary efficacy variable was the percentage of heartburn-free days from day 8 to the end of treatment.

RESULTS:

Single-dose esomeprazole was at least as effective as twice-daily lansoprazole for the primary end point of percentage of heartburn-free days during the study period (54.4% and 57.5%, respectively). Symptom scores improved from baseline in similar numbers of patients for heartburn (83.3% of patients in each group), acid regurgitation (76.8% vs 72.9%, P = .58), and epigastric pain (67.4% vs 61.1%, P = .32), and rescue antacid use was also similar (0.4 tablets/day vs 0.5 tablets/day, P = .50).

CONCLUSIONS:

Switching patients with persistent heartburn on a standard-dose proton pump inhibitor to a different proton pump inhibitor was as effective as increasing the proton pump inhibitor dosage to twice daily for controlling heartburn symptoms.

• Authors: Ronnie Fass, Stephen J Sontag, Barry Traxler, Mark Sostek
• Journal: Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association (Clin Gastroenterol Hepatol) Vol. 4 Issue 1 Pg. 50-6 (Jan 2006) ISSN: 1542-3565 [Print] United States
• PMID: 16431305 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• 2-Pyridinylmethylsulfinylbenzimidazoles
• Enzyme Inhibitors
• Proton Pump Inhibitors
• Lansoprazole
• Esomeprazole

Topics

• 2-Pyridinylmethylsulfinylbenzimidazoles
• Adult
• Aged
• Double-Blind Method
• Enzyme Inhibitors (administration & dosage, therapeutic use)
• Esomeprazole (administration & dosage, analogs & derivatives, therapeutic use)
• Female
• Heartburn (drug therapy)
• Humans
• Lansoprazole
• Male
• Middle Aged
• Proton Pump Inhibitors