Efficacy of esomeprazole 40 mg vs. lansoprazole 30 mg for healing moderate to severe erosive oesophagitis
Efficacy of esomeprazole 40 mg vs. lansoprazole 30 mg for healing moderate to severe erosive oesophagitis
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DOI：
10.1111/j.1365-2036.2005.02339.x
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发表时间：
2005-02-15
影响因子：
7.6
通讯作者：
Sostek, M
中科院分区：
文献类型：
--
作者：
Fennerty, MB;Johanson, JF;Sostek, M
背景资料：先前研究的次要分析表明，埃索美拉唑比兰索拉唑和奥美拉唑在中度或重度愈合方面更有效（洛杉矶C或D级）糜烂性食管炎（EE）。目的：比较埃索美拉唑与兰索拉唑在中度至重度EE患者中的前瞻性愈合率。方法：在这项多中心、随机、双盲、平行组试验中，经内镜检查证实为中度或重度EE的成人患者接受埃索美拉唑40 mg（n = 498）或兰索拉唑30 mg（n = 501）每日一次治疗，持续8周。主要终点是EE愈合至第8周。次要评估包括治疗评估的症状和安全性和tolerances.Results的解决：愈合时间有显着差异（P = 0.007），有利于埃索美拉唑。埃索美拉唑40 mg组第8周的估计愈合率为82.4%，兰索拉唑30 mg组为77.5%。埃索美拉唑组和兰索拉唑组分别有72%和64%的患者在第4周烧心消退（P = 0.005）。治疗组之间对其他GERD症状的控制相似。两种治疗方法的耐受性均良好。结论：与兰索拉唑30 mg每日一次相比，埃索美拉唑40 mg每日一次治疗8周后，在更多患者中治愈中度至重度EE的速度更快，治疗4周后在更多患者中缓解胃灼热。
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.