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Gaceta Medica de Mexico 2022A national survey in the general population showed that gastroesophageal reflux disease (GERD) is highly prevalent in Mexico. (Randomized Controlled Trial)
Randomized Controlled Trial
INTRODUCTION
A national survey in the general population showed that gastroesophageal reflux disease (GERD) is highly prevalent in Mexico.
OBJECTIVE
To compare the efficacy and safety of two isomers, dexrabeprazole (10 mg) vs. esomeprazole (20 mg), in the treatment of GERD for four weeks.
METHODS
Randomized, multicenter, prospective, double-blind phase III clinical trial in two groups that included 230 patients.
RESULTS
A statistically significant decrease in the severity of GERD symptoms (heartburn, regurgitation, epigastric pain and dysphagia), evaluated using a visual analogue scale, was observed with both treatments. Mean score for dexrabeprazole on Carlsson-Dent questionnaire at 28 days was 2.12, and for esomeprazole, 3.02. Both treatments were effective, with no statistically significant difference being recorded (p < 0.05). On SF-36 health questionnaire, both were observed to improve the quality-of-life score, with no significant difference being identified. Both drugs were well tolerated, and the adverse event incidence profile was low.
CONCLUSIONS
In the treatment of non-erosive GERD, the use of dexrabeprazole at 10 mg/day is as effective as esomeprazole 20 mg/day, with the advantage that the dose is lower with an appropriate safety profile.
Topics: Humans; Esomeprazole; Rabeprazole; Prospective Studies; Treatment Outcome; Gastroesophageal Reflux
PubMed: 36657136
DOI: 10.24875/GMM.M22000722 -
Medicine Nov 2022Proton-pump inhibitors (PPIs) and vonoprazan are recommended as first-line therapies for erosive esophagitis (EE). However, it is uncertain how the magnitude of efficacy... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Proton-pump inhibitors (PPIs) and vonoprazan are recommended as first-line therapies for erosive esophagitis (EE). However, it is uncertain how the magnitude of efficacy and safety of first-line therapy, the choice of individual PPIs or vonoprazan in the treatment of EE remains controversial. This study aimed to evaluate the efficacy and safety of vonoprazan and PPIs in healing esophageal mucosal injury in patients with EE.
METHODS
Relevant databases were searched to collect randomized controlled trials of proton pump inhibitors and vonoprazan in the treatment of reflux esophagitis up to December 2021. Studies on standard-dose PPIs or vonoprazan that were published in Chinese or English and assessed healing effects in EE were included in the analysis. Stata16.0 was used to conduct a network Meta-analysis to evaluate the efficacy and safety of the treatment.
RESULTS
A total of 41 literatures were included with 11,592 enrolled patients. For the endoscopic cure rate, all the PPIs and vonoprazan significantly improve compared to Placebo; Based on the surface under the cumulative ranking curve, Ilaprazole ranked first, followed by esomeprazole, vonoprazan, pantoprazole, lansoprazole, omeprazole, rabeprazole and placebo therapy ranked the last. For the rate of adverse events, there was no significant difference among all the PPIs, vonoprazan, and placebo.
CONCLUSIONS
Ilaprazole, esomeprazole and vonoprazan have more advantages in mucosal erosion healing, there was no significant difference in the comparative safety among all interventions.
Topics: Humans; Proton Pump Inhibitors; Esomeprazole; Network Meta-Analysis; Peptic Ulcer; Rabeprazole; Esophagitis, Peptic; Abdominal Injuries
PubMed: 36451489
DOI: 10.1097/MD.0000000000031807 -
Hypertension (Dallas, Tex. : 1979) Jun 2022Low sFlt-1 (soluble Fms-like tyrosine kinase-1) and ET-1 (endothelin-1) levels have been reported in preeclamptic women using proton pump inhibitors. (Randomized Controlled Trial)
Randomized Controlled Trial
Omeprazole Administration in Preterm Preeclampsia: a Randomized Controlled Trial to Study Its Effect on sFlt-1 (Soluble Fms-Like Tyrosine Kinase-1), PlGF (Placental Growth Factor), and ET-1 (Endothelin-1).
BACKGROUND
Low sFlt-1 (soluble Fms-like tyrosine kinase-1) and ET-1 (endothelin-1) levels have been reported in preeclamptic women using proton pump inhibitors.
METHODS
Here, we examined whether the proton pump inhibitor omeprazole could acutely reduce sFlt-1 and ET-1 (measured as CT-proET-1 [C-terminal pro-endothelin-1]), or increase free PlGF (placental growth factor) in 20 women with confirmed preeclampsia. Primary outcome was specified as the difference in sFlt-1, PlGF, or CT-proET-1 after 4 days of omeprazole versus 20 preeclamptic women not receiving omeprazole.
RESULTS
Mean maternal age was 30 years, and median gestational age was 30 weeks. Baseline sFlt-1 levels were identical in both groups, and the same was true for PlGF or CT-proET-1. After 4 days, sFlt-1 levels remained similar in women not receiving omeprazole compared with women receiving omeprazole, while the levels of PlGF and CT-proET-1 also did not differ between groups. Women receiving omeprazole had a similar prolongation of pregnancy after inclusion compared with those in the nonomeprazole group (median 15 versus 14 days). Except for a higher neonatal intubation rate in the nonomeprazole group (31% versus 4%, =0.02), there were no differences in maternal/perinatal complications. Finally, making use of the placenta perfusion model, we established that both omeprazole and its S-isomer, esomeprazole, when maternally applied, reached the fetal compartment (fetal-to-maternal ratio's 0.43-0.59), while only esomeprazole inhibited placental sFlt-1 release.
CONCLUSIONS
Administration of omeprazole to women with confirmed preeclampsia does not alter their circulating levels of sFlt-1, PlGF, or ET-1, arguing against a role of this drug as a treatment for this syndrome.
Topics: Adult; Biomarkers; Endothelin-1; Esomeprazole; Female; Humans; Infant; Infant, Newborn; Omeprazole; Placenta; Placenta Growth Factor; Pre-Eclampsia; Pregnancy; Proton Pump Inhibitors; Vascular Endothelial Growth Factor A; Vascular Endothelial Growth Factor Receptor-1
PubMed: 35341328
DOI: 10.1161/HYPERTENSIONAHA.122.19070 -
Alimentary Pharmacology & Therapeutics Feb 2003Omeprazole is a racemate, from which the R- and S-isomers can be isolated. At the cellular level, both of these isomers convert to the same inhibitor of the H+,K+-ATPase... (Review)
Review
Omeprazole is a racemate, from which the R- and S-isomers can be isolated. At the cellular level, both of these isomers convert to the same inhibitor of the H+,K+-ATPase and produce the same reduction in gastric acid secretion. However, the S-isomer, esomeprazole, is metabolized more slowly and reproducibly than the R-isomer and omeprazole, and therefore produces higher plasma concentrations for longer and, as a result, inhibits gastric acid production more effectively and for longer. Thus, esomeprazole has the pharmacological properties of a more effective form of treatment for disorders related to gastric acid secretion. Clinical studies have confirmed the anticipated increased efficacy, but have shown no evidence of impaired tolerability or increased toxicity when compared with omeprazole.
Topics: Drug Design; Enzyme Inhibitors; Esomeprazole; Gastric Acid; Humans; Isomerism; Omeprazole; Proton Pump Inhibitors
PubMed: 12614298
DOI: 10.1046/j.1365-2036.17.s1.1.x -
Scientific Reports Sep 2020The proton pump inhibitor omeprazole is administered to dogs with gastroduodenal ulceration or oesophagitis, whereas the neurokinin-1 receptor antagonist maropitant...
The proton pump inhibitor omeprazole is administered to dogs with gastroduodenal ulceration or oesophagitis, whereas the neurokinin-1 receptor antagonist maropitant citrate is licensed as an antiemetic drug. In people, omeprazole is overprescribed in hospitals, increasing the risk of adverse effects and imposing unnecessary costs in healthcare. To investigate the use of omeprazole and maropitant in our veterinary specialist hospital, we conducted a prospective observational study in its Medicine and Surgery wards, recording patient data and obtaining contemporaneous information from clinicians about their reasons for administering either drug. In doing so, we find omeprazole and maropitant are administered to a large proportion of dogs, including to many of those with no presenting signs suggestive of gastrointestinal disease. We find prescribing clinicians consider both drugs safe but often underestimate their financial cost. We find the stated reasons and objective predictors of administration of both drugs vary according to clinical setting but that these modalities yield concordant results. Reviewing the manner of administration and stated indications for use of both drugs, we find omeprazole is often administered outside dosing recommendations, and both drugs are frequently administered for aims that are unlikely to be achieved when considering their known biological effects in dogs. In conclusion, our work reveals probable overprescribing of omeprazole and maropitant citrate in hospitalised dogs, highlighting a need for initiatives to decrease inappropriate prescribing.
Topics: Animals; Dog Diseases; Dogs; Drug Prescriptions; Gastrointestinal Diseases; Hospitalization; Omeprazole; Practice Patterns, Physicians'; Prospective Studies; Quinuclidines
PubMed: 32978503
DOI: 10.1038/s41598-020-72950-3 -
PloS One 2014Proton pump inhibitors omeprazole and lansoprazole contain chiral sulfur atom and they are administered as a racemate, i.e. equimolar mixture of S- and R-enantiomers....
Proton pump inhibitors omeprazole and lansoprazole contain chiral sulfur atom and they are administered as a racemate, i.e. equimolar mixture of S- and R-enantiomers. The enantiopure drugs esomeprazole and dexlansoprazole have been developed and introduced to clinical practice due to their improved clinical and therapeutic properties. Since omeprazole and lansoprazole are activators of aryl hydrocarbon receptor (AhR) and inducers of CYP1A genes, we examined their enantiospecific effects on AhR-CYP1A pathway in human cancer cells and primary human hepatocytes. We performed gene reporter assays for transcriptional activity of AhR, RT-PCR analyses for CYP1A1/2 mRNAs, western blots for CYP1A1/2 proteins and EROD assay for CYP1A1/2 catalytic activity. Lansoprazole and omeprazole enantiomers displayed differential effects on AhR-CYP1A1/2 pathway. In general, S-enantiomers were stronger activators of AhR and inducers of CYP1A genes as compared to R-enantiomers in lower concentrations, i.e. 1-10 µM for lansoprazole and 10-100 µM for omeprazole. In contrast, R-enantiomers were stronger AhR activators and CYP1A inducers than S-enantiomers in higher concentrations, i.e. 100 µM for lansoprazole and 250 µM for omeprazole. In conclusion, we provide the first evidence of enantiospecific effects of omeprazole and lansoprazole on AhR signaling pathway.
Topics: Cell Line; Hepatocytes; Humans; Lansoprazole; Omeprazole; Proton Pump Inhibitors; Receptors, Aryl Hydrocarbon; Stereoisomerism
PubMed: 24887303
DOI: 10.1371/journal.pone.0098711 -
Alimentary Pharmacology & Therapeutics Jul 2002Proton pump inhibitor-based triple therapy is the most commonly used treatment for eradication of Helicobacter pylori, with pooled eradication rates of approximately... (Review)
Review
Proton pump inhibitor-based triple therapy is the most commonly used treatment for eradication of Helicobacter pylori, with pooled eradication rates of approximately 90%. In the USA, per protocol eradication rates with 10-day proton pump inhibitor-based triple therapy are approximately 85%. Esomeprazole, a new proton pump inhibitor that is the S-isomer of omeprazole and produces a greater inhibition of acid secretion than omeprazole, has recently been evaluated in the treatment of H. pylori. Seven-day twice daily triple therapy with esomeprazole 20 mg, amoxicillin 1 g and clarithromycin 500 mg provided intention-to-treat eradication rates of 86-90% and per protocol eradication rates of 90-91% in duodenal ulcer patients in Europe and Canada. Ten-day triple therapy with esomeprazole 40 mg q.d.s., amoxicillin 1 g b.d. and clarithromycin 500 mg b.d. achieved intention-to-treat eradication rates of 77-78% and per protocol eradication rates of 84-85% in USA duodenal ulcer patients. Thus, esomeprazole triple therapy with amoxicillin and clarithromycin is effective in the treatment of H. pylori, with eradication rates comparable to previously studied proton pump inhibitor-based triple therapies.
Topics: Anti-Bacterial Agents; Anti-Ulcer Agents; Drug Therapy, Combination; Duodenal Ulcer; Enzyme Inhibitors; Esomeprazole; Helicobacter Infections; Helicobacter pylori; Humans; Omeprazole; Proton Pump Inhibitors
PubMed: 12047270
DOI: 10.1046/j.1365-2036.16.s4.13.x -
Alternative Therapies in Health and... Nov 2022The frequency of gastric-cancer (GC) diagnosis has been increasing in recent years and often has no obvious symptoms at an early stage. Upon clinical diagnosis of early...
CONTEXT
The frequency of gastric-cancer (GC) diagnosis has been increasing in recent years and often has no obvious symptoms at an early stage. Upon clinical diagnosis of early GC (EGC), surgical treatment is generally recommended but as an invasive operation, surgical resection can't avoid postoperative gastrointestinal dysfunction (GID) and other problems.
OBJECTIVE
The study intended to evaluate the clinical benefits for EGC patients of auricular point-pressing with beans, combined with esomeprazole magnesium (EM), for relieving gastrointestinal dysfunction (GID) after endoscopic submucosal dissection (ESD), aiming to provide accurate and effective reference opinions for future clinical treatment.
DESIGN
The research team designed a retrospective analysis.
SETTING
The study took place at the Jiangsu Province Hospital of Chinese Medicine in Nanjing, Jiangsu, China.
PARTICIPANTS
Participants were 78 EGC patients who underwent ESD at the hospital between January 2019 and January 2021 and who had developed postoperative GID.
INTERVENTION
Thirty-seven patients chose to receive routine EM treatment, and they served as a control group. 41 patients chose to receive auricular point-pressing with bean plus EM intervention, and they served as a intervention group.
OUTCOME MEASURES
At baseline and postintervention, the research team measured the levels of serum motilin (MOT), substance P (SP), prealbumin (PAB), transferrin (TF), and albumin (ALB). They also recorded the time of intestinal peristalsis recovery, first exhaust, first defecation, normal food intake, and resolution of abdominal distension symptoms. Finally, they counted the incidence of adverse events during treatment.
RESULTS
The levels of MOT, SP, PAB, TF, and ALB significantly changed between baseline and postintervention in both groups (P < .05). In the intervention group as compared to the control group postintervention, the decreases in the levels of MOT PAB, TF, and ALB and the increase in the SP level were significantly greater in the control group than those of the intervention group (all P < .05). In addition, the intervention group showed a shorter recovery time related to postoperative intestinal function and normal food intake and resolution of abdominal distension symptoms than did the control group (all P < .05), with a lower incidence of adverse events.
CONCLUSIONS
Auricular point-pressing with beans plus EM can effectively alleviate the GID of EGC patients after ESD and help them to maintain normal gastrointestinal function, and its use is worth popularizing in clinical settings.
Topics: Humans; Retrospective Studies; Esomeprazole; Endoscopic Mucosal Resection; Stomach Neoplasms; China; Treatment Outcome
PubMed: 35839117
DOI: No ID Found -
Alimentary Pharmacology & Therapeutics Feb 2003Plasma concentration measurements have confirmed that the advantageous hepatic metabolism of esomeprazole results in a greater delivery of acid suppressant to the... (Review)
Review
Plasma concentration measurements have confirmed that the advantageous hepatic metabolism of esomeprazole results in a greater delivery of acid suppressant to the systemic circulation, compared with an equal dose of omeprazole. Also, this superior delivery has been shown to cause a more consistent and greater suppression of pentagastrin-stimulated gastric acid secretion by esomeprazole, 20 mg, compared with omeprazole, 20 mg. The superior acid-suppressant properties of esomeprazole have been revealed by extensive 24-h intragastric pH-monitoring studies. Compared with omeprazole, 20 mg, esomeprazole, 20 mg and 40 mg, has been shown to give superior outcomes on three key measures of antisecretory effect: (1) consistency amongst individuals; (2) duration over the 24-h cycle; (3) overall impact on pH. As there is a substantial increment of acid control from esomeprazole, 20 mg, to esomeprazole, 40 mg, this latter dose is the most appropriate to investigate for modern initial therapy of reflux disease, with the aim of achieving the highest possible response rates in the shortest possible time.
Topics: Anti-Ulcer Agents; Esomeprazole; Gastric Acid; Gastroesophageal Reflux; Humans; Hydrogen-Ion Concentration; Omeprazole; Pentagastrin; Proton Pump Inhibitors
PubMed: 12614299
DOI: 10.1046/j.1365-2036.17.s1.2.x -
Alimentary Pharmacology & Therapeutics Jul 2000Omeprazole and lansoprazole can be given in sodium bicarbonate as, respectively, simplified omeprazole suspension and simplified lansoprazole suspension. We previously... (Clinical Trial)
Clinical Trial Randomized Controlled Trial
BACKGROUND
Omeprazole and lansoprazole can be given in sodium bicarbonate as, respectively, simplified omeprazole suspension and simplified lansoprazole suspension. We previously found the antisecretory effect of omeprazole 20 mg given as simplified omeprazole suspension to be lower than with intact capsules. However, lansoprazole 30 mg as simplified lansoprazole suspension produced an effect similar to that seen with intact capsules.
AIM
To evaluate the absorption of both drugs when given orally as capsules or as suspensions in sodium bicarbonate.
METHODS
In random order, we gave 5-day courses of omeprazole 20 mg and lansoprazole 30 mg as capsules and as suspensions in sodium bicarbonate to 12 healthy women. Serial blood samples were taken on days 1 and 5 of each course for pharmacokinetic measurements.
RESULTS
There was impairment of omeprazole absorption when given as simplified omeprazole suspension. Maximum plasma concentration and area under the concentration/time curve were lower with simplified omeprazole suspension than with omeprazole capsules (P=0.034 and 0.013, respectively, on day 5). No differences were found in lansoprazole absorption when simplified lansoprazole suspension was compared with its standard capsule formulation. Relative bioavailability of omeprazole from simplified omeprazole suspension compared to the capsule was 58.4% on day 5. The corresponding value for lansoprazole was 84.7%.
CONCLUSIONS
Simplified omeprazole suspension 20 mg does not supply adequate omeprazole for systemic absorption. Lansoprazole absorption from simplified lansoprazole suspension is maintained.
Topics: 2-Pyridinylmethylsulfinylbenzimidazoles; Absorption; Administration, Oral; Adult; Anti-Ulcer Agents; Area Under Curve; Capsules; Female; Humans; Lansoprazole; Omeprazole; Sodium Bicarbonate; Suspensions
PubMed: 10886044
DOI: 10.1046/j.1365-2036.2000.00794.x