HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Gastric and esophageal pH in patients with Barrett's esophagus treated with three esomeprazole dosages: a randomized, double-blind, crossover trial.

AbstractBACKGROUND:
It has been suggested that patients with Barrett's esophagus (BE) are unusually resistant to the antisecretory effects of proton pump inhibitors (PPIs).
OBJECTIVES:
To compare intragastric and intraesophageal acidity in patients with BE receiving esomeprazole 40 mg three times daily (t.i.d.), esomeprazole 40 mg twice daily (b.i.d.), and esomeprazole 20 mg t.i.d.
METHODS:
In this randomized, double-blind, three-way crossover study, patients with long-segment BE received each of the three esomeprazole dosages for 5 days separated by 10-14-day washout periods. Intragastric and intraesophageal pHs were measured for 24 h on day 5.
RESULTS:
Among 31 patients with evaluable pH data, intragastric pH was >4.0 for 88.4%, 81.4%, and 80.4% of day 5 after treatment with esomeprazole 40 mg t.i.d., 40 mg b.i.d., and 20 mg t.i.d., respectively. Esomeprazole 40 mg t.i.d. was significantly more effective than the other dosages (p < 0.01). Intraesophageal pH was <4.0 for mean values of <5% of the monitoring period with all the three dosing regimens, but esophageal pH remained <4.0 for >5% of the time in 16%, 23%, and 19% of patients receiving esomeprazole 40 mg t.i.d., 40 mg b.i.d., and 20 mg t.i.d., respectively. All dosages were well tolerated.
CONCLUSIONS:
All the three esomeprazole dosages significantly decreased intragastric acidity and reduced esophageal acid exposure to mean normal values in the total group of patients with BE. However, abnormal esophageal acid exposure continued in 16-23% of patients despite the significant decrease in gastric acidity. These results suggest that the apparent "PPI resistance" described in patients with BE may be caused by their profound reflux diathesis rather than by gastric resistance to the antisecretory effects of PPIs.
AuthorsStuart J Spechler, Prateek Sharma, Barry Traxler, Douglas Levine, Gary W Falk
JournalThe American journal of gastroenterology (Am J Gastroenterol) Vol. 101 Issue 9 Pg. 1964-71 (Sep 2006) ISSN: 0002-9270 [Print] United States
PMID16848802 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Enzyme Inhibitors
  • Esomeprazole
Topics
  • Aged
  • Aged, 80 and over
  • Barrett Esophagus (drug therapy, metabolism, pathology)
  • Biopsy
  • Cross-Over Studies
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Enzyme Inhibitors (administration & dosage, therapeutic use)
  • Esomeprazole (administration & dosage, therapeutic use)
  • Esophageal pH Monitoring
  • Female
  • Follow-Up Studies
  • Gastric Acid (metabolism)
  • Gastric Acidity Determination
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Treatment Outcome

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: