Comparison of the efficacy of rabeprazole 10 mg and omeprazole 20 mg for the healing rapidity of peptic ulcer diseases.
OBJECTIVE
Rabeprazole has been known to inhibit H(+)/K(+)-ATPase more rapidly than omeprazole, the prototype proton pump inhibitor (PPI). The aim of this study was to demonstrate equivalence between low-dose rabeprazole 10 mg and omeprazole 20 mg for the healing rapidity of active peptic ulcer and for improvement of symptoms. Also, the effect of CYP2C19 genotypes on ulcer healing rapidity was investigated.


METHODS
A total of 112 patients with active peptic ulcer were randomized to receive either rabeprazole 10 mg q.d. or omeprazole 20 mg q.d. for 6 weeks. The remaining ratios (%) and complete healing of the ulcer were determined by endoscopy at 1 week and 6 weeks of treatment. The severity of ulcer pain was also investigated during treatment. CYP2C19 genotype was determined by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method.


RESULTS
The remaining ratio of peptic ulcers after 1 week and the complete healing rate after 6 weeks in the rabeprazole versus omeprazole group were 45.5% versus 50.3% (P = 0.475) and 80.6% versus 87.0% (P = 0.423), respectively. CYP2C19 genotypes had no effect on the remaining ratio of peptic ulcers after 1 week and the healing rate of peptic ulcers after 6 weeks in both groups. The proportions of patients with symptom improvement or resolution were comparable between the two groups.


CONCLUSIONS
Low-dose rabeprazole 10 mg has a similar efficacy for the healing rapidity of active peptic ulcer disease and symptom improvement compared with standard-dose omeprazole 20 mg.
Ji
Sangwon
S
Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, South Korea.
Kim
Hyun Soo
HS
Kim
Jae Woo
JW
Jee
Myeong Kwan
MK
Park
Kwang Wha
KW
Uh
Young
Y
Lee
Dong Ki
DK
Song
Jae Suk
JS
Baik
Soon Koo
SK
Kwon
Sang Ok
SO
D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000627:therapeutic use*; D000328:Adult; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D001189:Aryl Hydrocarbon Hydroxylases / Q000378:metabolism; D065731:Cytochrome P-450 CYP2C19; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D006899:Mixed Function Oxygenases / Q000378:metabolism; D009853:Omeprazole / Q000627:therapeutic use*; D010437:Peptic Ulcer / Q000188:drug therapy*; D011110:Polymorphism, Genetic; D064750:Rabeprazole; D016896:Treatment Outcome
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D004791:Enzyme Inhibitors; D064750:Rabeprazole; D006899:Mixed Function Oxygenases; D001189:Aryl Hydrocarbon Hydroxylases; C045793:CYP2C19 protein, human; D065731:Cytochrome P-450 CYP2C19; D009853:Omeprazole