Acid inhibition on the first day of dosing: comparison of four proton pump inhibitors.
BACKGROUND
Rapid and consistent acid suppression on the first day of dosing may be important in treating acid-related disorders.


OBJECTIVE
To compare the antisecretory activity and onset of action of single doses of rabeprazole, lansoprazole, pantoprazole, omeprazole capsule, omeprazole multiple unit pellet system (MUPS) tablet and placebo in healthy Helicobacter pylori-negative subjects.


METHODS
This cross-over, double-blind, randomized study was performed in 18 H. pylori-negative subjects. Twenty-four-hour intragastric pH monitoring was performed on the day of treatment (once-daily dose of rabeprazole 20 mg, lansoprazole 30 mg, pantoprazole 40 mg, omeprazole capsule 20 mg, omeprazole MUPS tablet 20 mg or placebo).


RESULTS
The intragastric pH (3.4) and time at pH > 4 during the 24 h post-dose (8.0 h) were significantly greater with rabeprazole than with lansoprazole, pantoprazole, omeprazole capsule, omeprazole MUPS tablet or placebo (P <or= 0.04 for rabeprazole vs. the others). Daytime and night-time pH values were higher with rabeprazole and lansoprazole than with pantoprazole, omeprazole capsule and omeprazole MUPS tablet (P </= 0.04).


CONCLUSIONS
Rabeprazole was the most potent acid inhibitor of all the proton pump inhibitors tested during the first day of dosing.
Pantoflickova
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Gastroenterology Department, CHUV, Lausanne, Switzerland; Eisai Ltd, London, UK. drahoslava.pantoflickova@chuv.hospvd.ch
Dorta
G
G
Ravic
M
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Jornod
P
P
Blum
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AL
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000293:Adolescent; D000328:Adult; D000863:Antacids / Q000008:administration & dosage*; D001562:Benzimidazoles / Q000008:administration & dosage; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D005744:Gastric Acid / Q000378:metabolism*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D064747:Lansoprazole; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000008:administration & dosage / Q000031:analogs & derivatives; D000077402:Pantoprazole; D054328:Proton Pump Inhibitors; D064750:Rabeprazole; D013454:Sulfoxides / Q000008:administration & dosage; D013997:Time Factors
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000863:Antacids; D001562:Benzimidazoles; D054328:Proton Pump Inhibitors; D013454:Sulfoxides; D064747:Lansoprazole; D064750:Rabeprazole; D000077402:Pantoprazole; D009853:Omeprazole