Review article: esomeprazole, 40 mg once daily, compared with lansoprazole, 30 mg once daily, in healing and symptom resolution of erosive oesophagitis.
BACKGROUND
Proton pump inhibitors are the most effective agents for treating erosive oesophagitis, but their relative efficacies have not been well characterized in large clinical trials.


OBJECTIVE
To compare standard doses of esomeprazole and lansoprazole in healing oesophagitis and resolving accompanying symptoms.


METHODS
This was a US, multicentre, randomized, double-blind trial and included 5241 adult patients (intention-to-treat) with endoscopically documented erosive oesophagitis. Patients were randomized to esomeprazole, 40 mg once daily, or lansoprazole, 30 mg once daily, for up to 8 weeks. The primary end-point, endoscopic healing at Week 8, was assessed using life-table analysis and a log-rank test. Secondary endpoints included healing at Week 4, healing according to baseline severity of oesophagitis, control of heartburn and side-effects.


RESULTS
Healing rates were 92.6% with esomeprazole and 88.8% with lansoprazole at Week 8 (P = 0.0001, log-rank test). A significant difference was also observed at Week 4. Sustained resolution of heartburn occurred faster and in a larger proportion of patients treated with esomeprazole. Both agents were well tolerated.


CONCLUSIONS
Esomeprazole produced significantly higher oesophagitis healing rates than lansoprazole over all grades of oesophagitis. Esomeprazole also provided better control of heartburn and was associated with a greater proportion of patients with sustained resolution of symptoms.
Vakil
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University of Wisconsin Medical School, Aurora Sinai Medical Center, 945 North 12th Street, Room 4040, Milwaukee, WI 53233, USA. nvakil@facstaff.wisc.edu
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000328:Adult; D004311:Double-Blind Method; D064098:Esomeprazole / Q000008:administration & dosage* / Q000031:analogs & derivatives; D004942:Esophagitis, Peptic / Q000188:drug therapy*; D006801:Humans; D064747:Lansoprazole; D054328:Proton Pump Inhibitors; D016896:Treatment Outcome
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D054328:Proton Pump Inhibitors; D064747:Lansoprazole; D064098:Esomeprazole