Novel measurement of rapid treatment success with ReQuest: first and sustained symptom relief as outcome parameters in patients with endoscopy-negative GERD receiving 20 mg pantoprazole or 20 mg esomeprazole.
OBJECTIVE
A prime concern for gastroesophageal reflux disease (GERD) patients is fast symptom control. Sparse valid information is available on the rapidity of the effect of proton pump inhibitors in providing symptom relief. The new reflux questionnaire ReQuest is validated for daily assessment of changes in GERD symptoms. Therefore, this study investigated the efficacy of 20 mg pantoprazole and 20 mg esomeprazole with regard to the time to symptom relief in patients with endoscopy-negative GERD (enGERD) using ReQuest.


METHODS
529 patients were treated with pantoprazole or esomeprazole over 4 weeks. ReQuest symptom scores were assessed daily. The mean and median times to first and sustained symptom relief were determined.


RESULTS
Median time to first symptom relief was 2 days for both drugs (intention-to-treat population). The median time to sustained symptom relief was 3 days shorter with pantoprazole (10.0 vs. 13.0 days). The Hodges-Lehmann estimator for the difference in time to reach first and sustained symptom relief between both groups was 0.00 days. For both variables the one-sided 95% CI (Moses) was [0.00; infinity[, documenting no significant differences between the treatment groups.


CONCLUSIONS
The rapidity of symptom control can be evaluated by clinically significant parameters using ReQuest. Pantoprazole and esomeprazole are equally effective in the time to first and sustained symptom relief.
Mönnikes
Hubert
H
Department of Medicine, Division Hepatology, Gastroenterology, and Endocrinology, Charité Medical Center--Campus Virchow Hospital, Medical School of Free University and Humboldt University, Berlin, Germany. hubert.moennikes@charite.de
Pfaffenberger
Bernd
B
Gatz
Gudrun
G
Hein
Jasper
J
Bardhan
Karna Dev
KD
D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D016001:Confidence Intervals; D018592:Cross-Over Studies; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D064098:Esomeprazole / Q000008:administration & dosage*; D004945:Esophagoscopy; D005260:Female; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000188:drug therapy*; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077402:Pantoprazole; D011336:Probability; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires / Q000592:standards; D013997:Time Factors; D016896:Treatment Outcome
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000077402:Pantoprazole; D064098:Esomeprazole