title: Comparison of the effects of esomeprazole 40 mg, rabeprazole 20 mg, lansoprazole 30 mg, and pantoprazole 40 mg on intragastrıc pH in extensive metabolizer patients with gastroesophageal reflux disease.
abstract: OBJECTIVE
  Studies on the therapeutic efficacy of proton pump inhibitors (PPIs) in patients with gastroesophageal reflux disease (GERD) have been recently published. In most of these studies, comparison of only two PPIs have been made. There are few studies on the comparison of four or more PPIs. We aimed to compare the acid inhibitory effects of esomeprazole 40 mg, rabeprazole 20 mg, lansoprazole 30 mg, and pantoprazole 40 mg on days 1 and 5 of treatment in patients with GERD, who were extensive metabolizers in regard to the CYP2C19 genotype.
  
  
  METHODS
  Helicobacter pylori-negative with typical symptoms of GERD patients were randomly divided into four treatment groups. Efficacy analysis on days 1 and 5 were performed on the four groups which comprised 10 (esomeprazole), 11 (rabeprazole), 10 (lansoprazole), and 10 (pantoprazole) patients.
  
  
  RESULTS
  On day 1 of PPI treatment, the mean percentage of time with intragastric Ph>4 were 54%, 58%, 60%, and 35% for the groups, respectively, and on day 5, these values were 67%, 60%, 68%, and 59%, respectively. Esomeprazole, rabeprazole, and lansoprazole were found to be superior to pantoprazole on the first day of treatment.
  
  
  CONCLUSIONS
  Pantoprazole is a less potent proton pump inhibitor than the other PPIs tested on the first day of treatment. When the time needed to raise the intragatric pH to over 4 was evaluated, esomeprazole was found to have the most rapid action, followed by lansoprazole and rabeprazole.
authors: Department of Gastroenterology, Kocaeli University School of Medicine, Kocaeli, Turkey. altaycelebi@kocaeli.edu.tr.
authors: Altay
authors: A
authors: Çelebi
authors: Dinçer
authors: D
authors: Aydın
authors: Orhan
authors: O
authors: Kocaman
authors: Buğra Tolga
authors: BT
authors: Konduk
authors: Ömer
authors: Ö
authors: Şentürk
authors: Sadetin
authors: S
authors: Hülagü
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000008:administration & dosage / Q000494:pharmacology; D000328:Adult; D018592:Cross-Over Studies; D065731:Cytochrome P-450 CYP2C19 / Q000378:metabolism*; D004311:Double-Blind Method; D064098:Esomeprazole / Q000008:administration & dosage / Q000494:pharmacology; D005260:Female; D005744:Gastric Acid / Q000737:chemistry*; D005764:Gastroesophageal Reflux / Q000188:drug therapy* / Q000235:genetics; D005838:Genotype; D006801:Humans; D006863:Hydrogen-Ion Concentration / Q000187:drug effects*; D064747:Lansoprazole / Q000008:administration & dosage / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D000077402:Pantoprazole; D054328:Proton Pump Inhibitors / Q000008:administration & dosage / Q000494:pharmacology*; D064750:Rabeprazole / Q000008:administration & dosage / Q000494:pharmacology; D016896:Treatment Outcome
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D054328:Proton Pump Inhibitors; D064747:Lansoprazole; D064750:Rabeprazole; D000077402:Pantoprazole; C045793:CYP2C19 protein, human; D065731:Cytochrome P-450 CYP2C19; D064098:Esomeprazole