Lansoprazole prevents recurrence of erosive reflux esophagitis previously resistant to H2-RA therapy. The Lansoprazole Maintenance Study Group.
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This randomized, double-blind study was designed to determine whether the proton pump inhibitor lansoprazole could prevent relapse among patients with healed erosive reflux esophagitis that had been resistant to healing with at least 3 months of H2-receptor antagonist therapy.By the end of the year, 13% of placebo patients remained healed compared with 67% of lansoprazole 15 mg and 55% of lansoprazole 30 mg patients (p < 0.001 for time to first relapse). All placebo patients were symptomatic by the end of the study whereas only one-third of the lansoprazole patients was symptomatic at the end of the 12-month study period. The two lansoprazole doses were comparably effective in maintaining healing and in symptom control and were well tolerated. Fasting serum gastrin values increased significantly to about 1.5-2 times the baseline values over the first 2 months of lansoprazole treatment; no further increase was noted.Erosive relapse can be prevented in most patients for up to 1 yr with lansoprazole 15 mg or 30 mg once daily.Keywords:
Lansoprazole
Reflux esophagitis
Esophagitis
Tolterodine
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Background: Lansoprazole (LAN) and omeprazole (OME) heal esophagitis effectively and to similar extents, but LAN has a faster effect on the relief of symptoms of gastroesophageal reflux. However, no strict comparison of the two proton pump inhibitors' effect on acid reflux and gastric acidity has been published. The aim of this study was to compare the effects of LAN and OME on gastroesophageal reflux with simultaneous measurements of gastric acidity in patients with established gastroesophageal reflux disease (GERD) and esophagitis. Methods: Fourteen patients with endoscopically verified erosive esophagitis and with a pretreatment esophageal 24-h pH measurement showing acid reflux to the esophagus participated in the study. This was a double-blind, randomized study with crossover design. Before (day 0) and on the last day (day 5) of each treatment period with encapsulated 30 mg LAN or 20 mg OME daily, 24-h intraesophageal and intragastric acidity were measured with antimony electrodes connected to an ambulatory pH recording system. Results
Lansoprazole
Esophagitis
Reflux esophagitis
Crossover study
Esophageal disease
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Helicobacter pylori eradication was recommended for the prevention of atrophic gastritis in gastroesophageal reflux disease (GERD) patients on long-term omeprazole treatment. It has been also shown that the treatment with proton pump inhibitors produces lower intragastric pH after H. pylori eradication in subjects with peptic ulcer and healthy individuals. The aim of the present study was to test the hypothesis of whether the efficacy of lansoprazole is reduced after the eradication of H. pylori in GERD patients with peptic esophagitis.Eight-hour intragastric pH recordings were performed before and after an 8-day course of lansoprazole (30 mg once daily) in 10 H. pylori-positive male patients with reflux esophagitis and were repeated after the H. pylori eradication. Intragastric acidity was measured by using an antimony electrode placed 10 cm below the cardia.Baseline median preprandial, post-prandial, total intragastric pH and the percentage of time with pH < 3 were not different before and after H. pylori eradication without lansoprazole treatment. During lansoprazole treatment, median post-prandial intragastric pH was lower (4 vs 2.7; P < 0.05) and the percentage of time with pH < 3 was longer (3.4%vs 41.8%; P < 0.05) after H. pylori eradication. Median total intragastric pH tended to be lower after eradication but no difference was found in preprandial median pH.In patients with reflux esophagitis treated with lansoprazole, intragastric pH increased significantly when H. pylori was present, especially in the post-prandial period, whereas baseline pH remained unchanged after H. pylori eradication.
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Proton pump inhibitors are the first-line treatment for reflux esophagitis. Because severe reflux esophagitis has very low prevalence in Japan, little is known about the effectiveness of proton pump inhibitors in these patients. This prospective multicenter study assessed the effectiveness of proton pump inhibitors for severe reflux esophagitis in Japan. Patients with modified Los Angeles grade C or D reflux esophagitis were treated with daily omeprazole (10 or 20 mg), lansoprazole (15 or 30 mg), or rabeprazole (10, 20, or 40 mg) for 8 weeks. Healing was assessed endoscopically, with questionnaires administered before and after treatment to measure the extent of reflux and dyspepsia symptoms. Factors affecting healing rates, including patient characteristics and endoscopic findings, were analyzed. Of the 115 patients enrolled, 64 with grade C and 19 with grade D reflux esophagitis completed the study. The healing rate was 67.5% (56/83), with 15 of the other 27 patients (55.6%) improving to grade A or B. No patient characteristic or endoscopic comorbidity was significantly associated with healing rate. Reflux and dyspepsia symptoms improved significantly with treatment. The low healing rate suggests the need of endoscopic examination to assess healing of reflux esophagitis at the end of therapy. (UMIN000005271).
Reflux esophagitis
Rabeprazole
Lansoprazole
Esophagitis
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This randomized, double-blind study was designed to determine whether the proton pump inhibitor lansoprazole could prevent relapse among patients with healed erosive reflux esophagitis that had been resistant to healing with at least 3 months of H2-receptor antagonist therapy.By the end of the year, 13% of placebo patients remained healed compared with 67% of lansoprazole 15 mg and 55% of lansoprazole 30 mg patients (p < 0.001 for time to first relapse). All placebo patients were symptomatic by the end of the study whereas only one-third of the lansoprazole patients was symptomatic at the end of the 12-month study period. The two lansoprazole doses were comparably effective in maintaining healing and in symptom control and were well tolerated. Fasting serum gastrin values increased significantly to about 1.5-2 times the baseline values over the first 2 months of lansoprazole treatment; no further increase was noted.Erosive relapse can be prevented in most patients for up to 1 yr with lansoprazole 15 mg or 30 mg once daily.
Lansoprazole
Reflux esophagitis
Esophagitis
Tolterodine
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Citations (56)
AIM:To clarify whether there is any difference in the symptom relief in patients with reflux esophagitis following the administration of four Proton pump inhibitors (PPIs). METHODS:Two hundred and seventy-four patients with erosive reflux esophagitis were randomized to receive 8 wk of 20 mg omeprazole (n = 68), 30 mg of lansoprazole (n = 69), 40 mg of pantoprazole (n = 69), 40 mg of esomeprazole (n = 68) once a day in the morning.Daily changes in heartburn and acid reflux symptoms in the first 7 d of administration were assessed using a six-point scale (0: none; 1: mild; 2: mild-moderate; 3: moderate; 4: moderate-severe; 5: severe). RESULTS:The mean heartburn score in patients treated with esomeprazole more rapidly decreased than those receiving other PPI.Complete resolution of heartburn was also more rapid in patients treated with esomeprazole for 5 d compared with omeprazole (P = 0.0018, P = 0.0098, P = 0.0027, P = 0.0137, P = 0.0069, respectively), lansoprazole (P = 0.0020, P = 0.0046, P = 0.0037, P = 0.0016, P = 0.0076, respectively), and pantoprazole (P = 0
Esomeprazole
Heartburn
Lansoprazole
Pantoprazole
Reflux esophagitis
Esophagitis
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Rabeprazole has a faster onset of antisecretory activity than omeprazole and lansoprazole. The aim of the present study was to clarify whether there is any difference in the speed of symptom relief in patients with reflux esophagitis following the administration of these three proton pump inhibitors (PPI).Eighty-five patients with erosive reflux esophagitis were randomized to receive 8 weeks of 20 mg of omeprazole (n = 30), 30 mg of lansoprazole (n = 25), or 20 mg of rabeprazole (n = 30) once a morning. Daily changes in heartburn and acid reflux symptoms in the first 7 days of administration were assessed using a six-point scale (0: none, 1: mild, 2: mild-moderate, 3: moderate, 4: moderate-severe, 5: severe).The mean heartburn score in patients administered rabeprazole decreased more rapidly than those given the other PPI. Complete heartburn remission also occurred more rapidly in patients administered rabeprazole (compared with omeprazole: P = 0.035, compared with lansoprazole: P = 0.038 by log-rank test). No differences were seen in the rate of endoscopic healing of reflux esophagitis at 8 weeks between the three treatment regimens.Rabeprazole may be more effective than omeprazole and lansoprazole for the rapid relief of heartburn symptoms in patients with reflux esophagitis.
Lansoprazole
Heartburn
Rabeprazole
Reflux esophagitis
Esophagitis
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Objective To clarify whether there is any difference in symptom relief in patients with reflux esophagitis administrating omeprazole,pantoprazole,lansoprazole,esomeprazole.Methods Three hundred and twenty patients with reflux esophagitis were randomly divided to receive 8 weeks of 20 mg omeprazole,40 mg pantoprazole,30 mg lansoprazole,40 mg esomeprazole once a day in the morning.Daily changes in heartburn and acid reflux symptoms in the first 7 days of administration were assessed using a six-point scale(0:none,1:mild,2:mild-moderate,3:moderate,4:moderate-severe,5:severe).Results The mean heartburn scores in patients administrating esomeprazole decreased more rapidly than that in patients administrating other PPIs.Complete resolution of heartburn was also more rapidly in patients treated with esomeprazole for 5 days compared with omeprazole(P=0.0054,0.0072,0.0089,0.0107,0.0134,respectively),lansoprazole(P=0.0043,0.0034,0.0044,0.0011,0.0052,respectively),and pantoprazole(P=0.0156,0.0003,0.0005,0.0024,0.0172,respectively).There was no significant difference in endoscopic healing rate of reflux esophagitis at 8 weeks among the four groups.Conclusion Esomeprazole may relief heartburn and reflux symptoms faster than omeprazole,pantoprazole and lansoprazole in patients with reflux esophagitis.
Esomeprazole
Heartburn
Lansoprazole
Pantoprazole
Reflux esophagitis
Esophagitis
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[Objective] To compare the effects of three kinds of proton pump inhibitors such as Rabeprazole,Lansoprazole,Omeprazole in reflux esophagitis.[Methods] 98 reflux esophagitis patients were divided into three groups.Among these groups,34 patients were administrated for rabeprazole,33 for lansoprazole and 32 for omeprazole.Three groups were all treated with mosapride.Observed the treatment effects at 2ed,4th and 8th week as well as symptoms and changes in endoscope at 8th week.[Results] After being treated in 2ed,4th and 8th,the effect of rabeprazole group was better than other groups(P﹤ 0.05).At 8th week,the endoscope result indicated the rabeprazole group was better than other groups(P﹤0.05).[Conclusion] Rabeprazole is most effective drug among three kinds of PPI.
Rabeprazole
Lansoprazole
Mosapride
Reflux esophagitis
Endoscope
Esophagitis
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The clinical efficacy of proton pump inhibitors (PPI, omeprazole 20 mg or lansoprazole 30 mg), once daily, after breakfast, was studied in patients with erosive/ulcerative reflux esophagitis. The following results were obtained. 1) Twenty-four hour esophageal pH monitoring was performed before treatment and on 7th day of PPI medications. Omeprazole reduced the percent time pH less than 4 from 29.1 to 1.2 and lansoprazole from 68.0 to 2.4. 2) The cumulative disappearance rate of overall symptom was 52% after 1 week and 62% after 2 weeks with omeprazole these were 66% and 91%, and with lansoprazole respectively 3) The endoscopic healing rate was 63% was after 2 weeks and 76% after 4 weeks with omeprazole medication, and 76% and 97% respectively with lansoprazole. These results indicate that PPI medication inhibits the acid reflux almost completely and is a more useful therapeutic agent for GERD than H2-antagonists.
Lansoprazole
Reflux esophagitis
Esophagitis
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Patients with erosive gastroesophageal reflux disease (GERD) have rapid recurrence after treatment withdrawal. The aim is to study the influences of CYP2C19 polymorphism on recurrence of GERD during proton pump inhibitor maintenance therapy.Ninety-nine patients with initial healing of GERD (judged by endoscopy) after 8 wk of treatment with PPIs were enrolled into maintenance therapy for 6 mo with rabeprazole (10 mg/day), omeprazole (20 mg/day) or lansoprazole (15 mg/day). The recurrence of GERD symptoms in the maintenance therapy was assessed by a QUEST questionnaire.The recurrence rate of GERD symptoms in the group of CYP2C19 homozygous extensive metabolizers (38.5%) was significantly greater than those in groups of heterozygous extensive metabolizers (10.9%) and poor metabolizers (5.6%). The recurrence rates in patients treated with omeprazole (25%) and lansoprazole (30.8%) were significantly greater than that with rabeprazole (4.4%). The gender, age and H. pylori did not significantly affect the rate.The CYP2C19 genotypes affected the recurrence rate of GERD symptoms during PPI maintenance therapy. The reason for the low recurrence rate with 10 mg/day rabeprazole possibly is due to its sufficient acid suppression independent of CYP2C19 genotypes in Japanese patients.
Rabeprazole
Lansoprazole
Esophagitis
Reflux esophagitis
Maintenance therapy
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