A multicentre randomised trial to compare the efficacy of omeprazole versus rabeprazole in early symptom relief in patients with reflux esophagitis
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- 作者：Akihito Nagahara (1)
Tsuyoshi Suzuki (2)
Naoyoshi Nagata (3)
Nozomu Sugai (4)
Yoshiaki Takeuchi (5)
Kouichi Sakurai (6)
Masaki Miyamoto (7)
Kazuhiko Inoue (8)
Junichi Akiyama (3)
Katsuhiro Mabe (9)
Ichiro Konuma (10)
Tomoari Kamada (11)
Ken Haruma (11) - 关键词：Omeprazole ; Rabeprazole ; Proton pump inhibitor ; Reflux esophagitis ; Symptom relief
- 刊名：Journal of Gastroenterology
- 出版年：2014
- 出版时间：December 2014
- 年：2014
- 卷：49
- 期：12
- 页码：1536-1547
- 全文大小：598 KB
- 参考文献：1. Donnellan C, Sharma N, Preston C, Moayyedi P. Medical treatments for the maintenance therapy of reflux oesophagitis and endoscopic negative reflux disease. Cochrane Database Syst Rev. 2005;2:CD003245.
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Tsuyoshi Suzuki (2)
Naoyoshi Nagata (3)
Nozomu Sugai (4)
Yoshiaki Takeuchi (5)
Kouichi Sakurai (6)
Masaki Miyamoto (7)
Kazuhiko Inoue (8)
Junichi Akiyama (3)
Katsuhiro Mabe (9)
Ichiro Konuma (10)
Tomoari Kamada (11)
Ken Haruma (11)
1. Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan
2. Department of Gastroenterology, Tokyo Metropolitan Police Hospital, Tokyo, Japan
3. Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Tokyo, Japan
4. Department of Gastroenterology, KKR Sapporo Medical Center, Hokkaido, Japan
5. Department of Gastroenterology, Showa University School of Medicine, Tokyo, Japan
6. Department of Gastroenterology and Hepatology, Kumamoto University, Kumamoto, Japan
7. Department of General Internal Medicine, Hiroshima Prefectural Hospital, Hiroshima, Japan
8. Department of General Medicine, Kawasaki Medical School, Okayama, Japan
9. Division of Endoscopy, Hokkaido University Hospital, Hokkaido, Japan
10. Konuma Clinic, Tochigi, Japan
11. Department of Gastroenterology, Kawasaki Medical School, Okayama, Japan - ISSN：1435-5922
文摘
Background Proton pump inhibitors (PPIs) are affected by cytochrome P450 2C19 (CYP2C19) polymorphisms. This study compared the effect of two PPIs on early symptom relief in Japanese patients with reflux esophagitis, classified by the CYP2C19 phenotype. Methods Patients with reflux esophagitis were randomised to treatment with omeprazole 20?mg or rabeprazole 10?mg once daily. The CYP2C19 phenotype [homozygous extensive metaboliser (homoEM), heterozygous extensive metaboliser (heteroEM) or poor metaboliser (PM)] of each patient was determined. The primary efficacy endpoint was early, sufficient (Global Overall Symptom scale score 1 or 2), sustained (maintained for ??days) reflux symptom relief. Results Of the 199 patients included in this analysis, the proportion achieving sufficient, sustained reflux symptom relief was higher with omeprazole than with rabeprazole on day?1 (35.6 vs. 22.4?%; p?=?0.041) and day?2 (43.6 vs. 28.6?%; p?=?0.028); there was no significant difference between the two groups on days?3-. Among patients with the CYP2C19 PM phenotype, sufficient, sustained reflux symptom relief was higher with omeprazole than with rabeprazole on days?4- (62.5-6.9 vs 31.6?%; p?≤?.03); differences were not significant on days 1-, or among those with the homoEM or heteroEM phenotypes on days?1-. Conclusions In Japanese patients with reflux esophagitis, omeprazole 20?mg is more effective than rabeprazole 10?mg at achieving early, sufficient, sustained reflux symptom relief in individuals with the CYP2C19 PM phenotype, and is similarly effective to rabeprazole 10?mg in those with heteroEM or homoEM phenotypes.