Efficacy of esomeprazole 40 mg vs. lansoprazole 30 mg for healing moderate to severe erosive oesophagitis

• Published in: Alimentary pharmacology & therapeutics Vol. 21; no. 4; pp. 455 - 463
• Main Authors: Fennerty, M. B., Johanson, J. F., Hwang, C., Sostek, M.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 15.02.2005; Blackwell
• Subjects: 2-Pyridinylmethylsulfinylbenzimidazoles; Adult; Aged; Anti-Ulcer Agents - administration & dosage; Anti-Ulcer Agents - adverse effects; Biological and medical sciences; Digestive system; Double-Blind Method; Esomeprazole - administration & dosage; Esomeprazole - adverse effects; Esophagitis, Peptic - drug therapy; Female; Gastroenterology. Liver. Pancreas. Abdomen; Heartburn - drug therapy; Humans; Lansoprazole; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Prospective Studies; Proton Pump Inhibitors; Treatment Outcome; Wound Healing; Enzyme; Esophageal disease; H; Enzyme inhibitor; Esophagitis; Antiulcer agent; K; Proton pump inhibitor; Benzimidazole derivatives; Healing agent; Antisecretory agent; Esomeprazole; Digestive diseases; exchanging ATPase; Hydrolases; Lansoprazole
• ISSN: 0269-2813; 1365-2036
• DOI: 10.1111/j.1365-2036.2005.02339.x

Summary Background : Secondary analyses from previous studies indicated that esomeprazole was more effective than lansoprazole and omeprazole in healing moderate or severe (Los Angeles grades C or D) erosive oesophagitis (EE). Aim : To compare prospectively healing rates with esomeprazole vs. lansoprazole in patients with moderate to severe EE. Methods : In this multicentre, randomized, double‐blind, parallel‐group trial, adult patients with endoscopically confirmed moderate or severe EE received esomeprazole 40 mg (n = 498) or lansoprazole 30 mg (n = 501) once daily for up to 8 weeks. The primary end point was EE healing through week 8. Secondary assessments included investigator‐assessed resolution of symptoms and safety and tolerability. Results : Time to healing was significantly different (P = 0.007), favouring esomeprazole. Estimated healing rates at week 8 were 82.4% with esomeprazole 40 mg and 77.5% with lansoprazole 30 mg. Heartburn resolved at week 4 in 72% and 64% of patients who received esomeprazole and lansoprazole, respectively (P = 0.005). Control of other GERD symptoms was similar between treatments. Both treatments were well tolerated. Conclusions : With 8 weeks’ treatment, esomeprazole 40 mg once daily heals moderate to severe EE faster and in more patients, and resolves heartburn in more patients after 4 weeks of treatment, than lansoprazole 30 mg once daily.