title: Does BMI affect the clinical efficacy of proton pump inhibitor therapy in GERD? The case for rabeprazole.
abstract: BACKGROUND
  Increased BMI is associated with a higher risk of gastroesophageal reflux disease.
  
  
  OBJECTIVE
  To investigate whether overweight/obesity (BMI≥25 kg/m(2)) affects rabeprazole clinical efficacy versus omeprazole in patients with erosive esophagitis (EE).
  
  
  METHODS
  Post-hoc analysis of EE healing rate and symptom response stratified by patient BMI was performed on data from a multicenter, double-blind, randomized, 4-to-8-week trial comparing EE healing with rabeprazole (20 mg daily) and omeprazole (20 mg daily). Analysis of variance, two-sample t-test, Blackwelder's test for equivalence, log-rank, and Cochran-Mantel-Haenszel tests were used to analyze comparisons.
  
  
  RESULTS
  In the two BMI groups (<25 kg/m(2) and ≥25 kg/m(2) respectively), rabeprazole and omeprazole were equally effective for mucosal healing regardless of patient's BMI (N=542, P>0.05). However, in overweight/obese patients, rabeprazole was significantly faster than omeprazole in inducing heartburn relief during the first treatment week (P<0.0001).
  
  
  CONCLUSIONS
  Results of this study show that the clinical efficacy of rabeprazole is maintained in overweight/obese patients with gastroesophageal reflux disease and suggest that this subgroup of patients may derive, from rabeprazole, even greater benefit than lean patients.
authors: Department and Chair of Gastroenterology, University of Milan, Italy.
authors: Fabio
authors: F
authors: Pace
authors: Bogdana
authors: B
authors: Coudsy
authors: Byron
authors: B
authors: DeLemos
authors: Yijun
authors: Y
authors: Sun
authors: Jim
authors: J
authors: Xiang
authors: John
authors: J
authors: LoCoco
authors: Stefania
authors: S
authors: Casalini
authors: Honglan
authors: H
authors: Li
authors: Iva
authors: I
authors: Pelosini
authors: Carmelo
authors: C
authors: Scarpignato
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D015992:Body Mass Index; D004311:Double-Blind Method; D004942:Esophagitis, Peptic / Q000188:drug therapy / Q000209:etiology; D005260:Female; D005764:Gastroesophageal Reflux / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D009853:Omeprazole / Q000009:adverse effects / Q000627:therapeutic use; D050177:Overweight / Q000150:complications*; D054328:Proton Pump Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D064750:Rabeprazole; D012189:Retrospective Studies; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D054328:Proton Pump Inhibitors; D064750:Rabeprazole; D009853:Omeprazole