A review of esomeprazole in the treatment of gastroesophageal reflux disease (GERD)

Figures & data

Table 1 Gastric acidity, expressed as the percentage of time with intragastric pH >4.0 on day 5 in individuals treated with esomeprazole, omeprazole, pantoprazole, and rabeprazole in cross-over randomized pharmacodynamic studies

Reference	Study design	Patient/individual selection	PPIs compared	Number of individuals	Percentage of time with intragastric pH >4.0
Lind et al 2000	Double-blind, randomized, cross-over	GERD symptoms	Eso40 vs eso20 vs ome 20 od	38	69.8% vs 53.0 vs 43.7% p < 0.01
Rohss et al 2002	Open-label, randomized, cross-ove	GERD symptoms	Eso40 vs ome 40 od	130	68.4% vs 62.0%, p < 0.001
Wilder-Smith et al 2003	Open-label, randomized, cross-over	Healthy volunteers	Eso40 vs lan30 od	24	65% vs 53%, p < 0.001
Wilder-Smith et al 2003	Open-label, randomized, cross-over	Healthy volunteers	Eso40 vs rabe20 od	23	61% vs 45.1%, p = 0.005
Miner et al 2003	Open-label, randomized, cross-over	GERD symptoms	Eso40 vs lan30 vs ome20 vs panto40 vs rabe20 od	34	58.4% vs 47% vs 49.1 vs 50.5%, p < 0.001
Rohss et al 2004	Open-label, randomized cross-over	GERD symptoms	Eso40 vs lan30 od	36	57.5% vs 44.6%, p < 0.0001
Rohss et al 2004	Open-label, randomized, cross-over	GERD symptoms	Eso40 vs ome20 od	38	70% vs 43.8%, p < 0.0001
Rohss et al 2004	Open-label, randomized, cross-over	GERD symptoms	Eso40 vs panto40 od	32	67.1% vs 45%, p < 0.001
Rohss et al 2004	Open-label, randomized, cross-over	GERD symptoms	Eso40 vs rabe20 od	35	59.6% vs 44.6%, p < 0.0001
Miehlke et al 2005	Single-blind, randomized, cross-over	Healthy volunteers	Eso40 vs panto bd	30	85.4% vs 63.6%, p = 0.0001
Johnson et al 2005	Open-label, randomized, cross-over	GERD symptoms 2005	Eso40 bd vs lan30 bd vs eso40 od vs lan30 od	45	81.3% vs 65.4% vs 60.1% vs 51.3% p < 0.05

Abbreviations: Eso, esomeprazole; GERD, gastroesophageal reflux disease; lan, lansoprazole; ome, omeprazole; PPI, proton-pump inhibitor; panto, pantoprazole; rabe, rabeprazole.

Table 2 Randomized trials evaluating the efficacy of esomeprazole vs other proton-pump inhibitors in healing erosive GERD

Reference	Study design	Number of patients	PPIs compared	Healing rates intention-to-treat analysis
				4 weeks	8 weeks
Kahrilas et al 2000	Double-blind, randomized	1960	Eso40 vs eso20 vs ome20 od	75.9% vs 70.5% vs 64.7%, p < 0.05 for eso40 vs p = 0.09 for eso20 vs ome20	94.1% vs 89.9% vs 86.9%, p < 0.05 for all comparisons
Richter et al 2001	Double-blind, randomized	2425	Eso40 vs ome20 od	81.7% vs 68.7%, p < 0.001	93.7% vs 84.2%, p < 0.001
Schmitt et al 2006	Double-blind, randomized	1148	Eso40 vs ome20 od	68.2% vs 66.3%, p = 0.385	87% vs 85.8, p = 0.552
Castell et al 2002	Double-blind, randomized	5241	Eso40 vs lan30 od	79.4% vs 75.1%, p < 0.05	92.6% vs 88.8%, p < 0.0001
Howden et al 2002	Double-blind, randomized	284	Eso40 vs lan30 od	78.3% vs 77%, p > 0.05	91.4% vs 89.1, p > 0.05
Fennerty et al 2005	Double-blind, randomized	1001	Eso40 vs lan30 od	55.8% vs 47.5%, p = 0.005	82.4% vs 77.5%, p = 0.005
Gillessen et al 2004	Double-blind, randomized	227	Eso40 vs panto40 od	72% vs 74%, p > 0.05a	92% vs 90%, p > 0.05b
Labenz et al 2005b	Double-blind, randomized	3170	Eso40 vs panto40 od	81% vs 74.5%, p < 0.001	92% vs 95.5%, p < 0.001

a Healing rates regarding the first follow-up visit at 4 or 6 weeks in this study

b Healing rates at the second follow-up visit at 8 or 10 weeks in this study

Notes: No randomized studies comparing esomeprazole with rabeprazole for healing erosive GERD were found.

Abbreviations: Eso, esomeprazole; ome, omeprazole; lan, lansoprazole; panto, pantoprazole; PPI, proton-pump inhibitor.

Table 3 Randomized trials evaluating the efficacy of esomeprazole vs other PPIs in combined endoscopic and symptomatic maintenance of healed erosive GERD

Reference	Study design	Number of patients	PPIs compared	Maintenance rates at 6 months
Lauritsen et al 2003	Double-blind, randomized	1224	Eso20 vs lan15 od	83 % vs 74%, p < 0.0001
Labenz et al 2005a	Double-blind, randomized	2766	Eso20 vs panto20 od	87% vs 74.9%, p < 0.0001
Devault et al 2006	Double-blind, randomized	1026	Eso20 vs lan15 od	84.5% vs 75.9%, p < 0.0007

Notes:No randomized studies comparing esomeprazole with rabeprazole or omeprazole as to healing erosive GERD were found.

Abbreviations:Eso, esomeprazole; lan, lansoprazole; panto, pantoprazole; PPI, proton-pump inhibitor.

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