Does BMI affect the clinical efficacy of proton pump inhibitor therapy in GERD? The case for rabeprazole.

Increased BMI is associated with a higher risk of gastroesophageal reflux disease. To investigate whether overweight/obesity (BMI≥25 kg/m2) affects rabeprazole clinical efficacy versus omeprazole in patients with erosive esophagitis (EE). Post-hoc analysis of EE healing rate and symptom response stratified by patient BMI was performed on data from a multicenter, double-blind, randomized, 4-to-8-week trial comparing EE healing with rabeprazole (20 mg daily) and omeprazole (20 mg daily). Analysis of variance, two-sample t-test, Blackwelder’s test for equivalence, log-rank, and Cochran–Mantel–Haenszel tests were used to analyze comparisons. In the two BMI groups ( 0.05). However, in overweight/obese patients, rabeprazole was significantly faster than omeprazole in inducing heartburn relief during the first treatment week (P<0.0001). Results of this study show that the clinical efficacy of rabeprazole is maintained in overweight/obese patients with gastroesophageal reflux disease and suggest that this subgroup of patients may derive, from rabeprazole, even greater benefit than lean patients.