title: Safety and efficacy of delayed release rabeprazole in 1- to 11-month-old infants with symptomatic GERD.
abstract: OBJECTIVE
  : The efficacy and safety of rabeprazole, a proton pump inhibitor, were studied in infants with gastroesophageal reflux disease (GERD).
  
  
  METHODS
  Infants ages 1 to 11 months, with symptomatic GERD resistant to conservative therapy and/or previous exposure to acid-suppressive medications, were screened. After scoring >16 on a GERD symptom score (Infant Gastroesophageal Reflux Questionnaire-Revised [I-GERQ]), 344 infants were enrolled in a 1- to 3-week open-label (OL) phase and received rabeprazole 10 mg/day. Following caregiver-rated clinical improvement during the OL phase, patients were randomized to placebo, rabeprazole 5 mg, or rabeprazole 10 mg in the ensuing 5-week double-blind (DB) withdrawal phase. Primary endpoints evaluated from DB baseline to the end of the DB withdrawal phase included frequency of regurgitation, weight-for-age z score, and daily and weekly GERD symptom scores.
  
  
  RESULTS
  Overall, 231 (86%) of the 268 randomized infants (placebo: 90; rabeprazole 5 mg: 90; rabeprazole 10 mg: 88) completed the study. Efficacy endpoints were similarly improved during the OL phase in all of the groups, and continued improving during the DB withdrawal phase with no difference between the placebo and combined rabeprazole groups. Mean decrease in frequency of regurgitation (-0.79 vs -1.20 times per day; P = 0.168), in I-GERQ-Revised scores (-3.6 [-25%] vs -3.9 points [-27%]; P = 0.960), in I-GERQ-Daily Diary scores (-1.87 [-19%] vs -1.85 [-19%]; P = 0.968), and increase in weight-for-age z scores (mean [standard deviation]: 0.11 [0.329] vs 0.14 [0.295]; P = 0.440) indicated equal improvement. Equal percentages (47%) reported adverse events in placebo and combined rabeprazole groups, with no new safety signals emerging.
  
  
  CONCLUSIONS
  In those infants with GERD who improved with rabeprazole during the OL phase, improvements in symptoms and weight were similar in those who continued rabeprazole and those withdrawn to placebo during a 5-week DB phase.
authors.affiliation: *WK Pediatric Gastroenterology & Research, Shreveport, LA †Instytut "Pomnik-Centrum Zdrowia Dziecka," Warsaw, Poland ‡Janssen Research & Development, LLC, Raritan, NJ.
authors.forename: Sunny
authors.initials: S
authors.lastname: Hussain
authors.forename: Jaroslaw
authors.initials: J
authors.lastname: Kierkus
authors.forename: Peter
authors.initials: P
authors.lastname: Hu
authors.forename: Diane
authors.initials: D
authors.lastname: Hoffman
authors.forename: Ray
authors.initials: R
authors.lastname: Lekich
authors.forename: Sheldon
authors.initials: S
authors.lastname: Sloan
authors.forename: William
authors.initials: W
authors.lastname: Treem
mesh_terms: D001835:Body Weight / Q000187:drug effects; D004311:Double-Blind Method; D005764:Gastroesophageal Reflux / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D054328:Proton Pump Inhibitors / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D064750:Rabeprazole / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014839:Vomiting / Q000209:etiology / Q000517:prevention & control
chemical_list: D054328:Proton Pump Inhibitors; D064750:Rabeprazole