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      A double-blind, randomized comparison of omeprazole Multiple Unit Pellet System (MUPS) 20 mg, lansoprazole 30 mg and pantoprazole 40 mg in symptomatic reflux oesophagitis followed by 3 months of omeprazole MUPS maintenance treatment: a Dutch multicentre trial.

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      Journal: European Journal of Gastroenterology & Hepatology

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          Abstract

          Proton pump inhibitors (PPIs) have proved to be effective in treating reflux oesophagitis. Until now, no study had compared the PPIs omeprazole Multiple Unit Pellet System (MUPS), lansoprazole and pantoprazole in patients with reflux oesophagitis.

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          Most cited references28

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          Well-being and gastrointestinal symptoms among patients referred to endoscopy owing to suspected duodenal ulcer.

          E Dimenäs, H Glise, J Svedlund … (1995)
          Few studies have evaluated quality of of life (QoL) in patients with upper gastrointestinal diseases, and there is a lack of validated measures for use in gastroenterology. The applicability and relevance of self-administered questionnaires such as the Psychological General Well-Being (PGWB) index and the Gastrointestinal Symptoms referred to endoscopy because of suspected duodenal ulcer were evaluated. In total, 1526 patients with suspected duodenal ulcer were screened for inclusion in a clinical study. On the basis of medical history and endoscopy, 1424 patients who completed the questionnaire before endoscopy were classified in five diagnostic groups: oesophagitis, gastric ulcer, duodenal ulcer, negative endoscopy, and gastritis duodenitis. Irrespective of diagnosis, all patient groups reported a considerable decrease in their general well-being (mean score, 85, compared with 105 in healthy populations) with no significant differences between the groups. The results of the GSRS, however, showed statistically significant differences between the groups in dimensions depicting Abdominal pain, Reflux, Indigestion, and Diarrhoea Syndrome. The results of the study showed that, irrespective of endoscopic findings, patients complaining of upper gastrointestinal symptoms have a low degree of general well-being. The symptoms profiles in the different diagnostic groups vary considerably.
          Article 0 comments Cited 79 times – based on 0 reviews     Review now
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            Curing Helicobacter pylori infection in patients with duodenal ulcer may provoke reflux esophagitis.

            J Labenz, AL Blum, E Bayerdörffer … (1997)
            We have shown previously that cure of Helicobacter pylori infection leads to the disappearance of acid-neutralizing substances. Also, patients with ulcer after cure may gain weight. The aim of this study was to investigate whether cure of the infection increases the risk of reflux esophagitis. Patients with duodenal ulcer without reflux esophagitis at the time of Helicobacter treatment were followed up prospectively after cure of the infection (n = 244) or after diagnosis of persisting infection (n = 216). All patients underwent endoscopy at 1-year intervals or when upper gastrointestinal symptoms recurred. H. pylori infection was assessed by rapid urease test and histology. The estimated incidence of reflux esophagitis within 3 years was 25.8% after cure of the infection and 12.9% when the infection was ongoing (P < 0.001). Patients who developed reflux esophagitis after the cure had a more severe body gastritis before cure (odds ratio, 5.5; 95% confidence interval [CI], 2.8-13.6), gained weight more frequently after cure (odds ratio, 3.2; 95% CI, 1.2-9.4), and were predominantly men (odds ratio, 3.6; 95% CI, 1.1-10.6). A considerable proportion of patients with duodenal ulcer treated for H. pylori will develop reflux esophagitis; risk factors are male sex, severity of corpus gastritis, and weight gain.
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              Healing and relapse of severe peptic esophagitis after treatment with omeprazole.

              David J Hetzel, John Dent, William Reed … (1988)
              We have studied the response of erosive or ulcerative esophagitis to treatment with omeprazole and its subsequent relapse on cessation of therapy in 196 patients. In the first phase of the study omeprazole (20 or 40 mg daily) was compared with placebo in 64 patients. After 4 wk there was endoscopic healing in 81% (25 of 31) of omeprazole-treated patients and in only 6% (2 of 32) of placebo-treated patients. Endoscopic healing of esophagitis was accompanied by symptom relief and histologic healing of ulceration. In the second (dose finding) phase a further 132 patients were randomized to omeprazole (20 or 40 mg daily) and endoscopic healing was assessed. In patients with the mildest grade of ulcerative esophagitis (grade 2), healing occurred at 4 wk in 87% receiving 20 mg and in 97% receiving 40 mg. In patients with grade 3 esophagitis, 67% (20 mg) and 88% (40 mg) were healed. Less than half the patients with grade 4 esophagitis (Barrett's ulcers or confluent ulceration) healed with either 20 mg (48%) or 40 mg (44%). Regression analysis in the 164 omeprazole-treated patients showed no evidence that healing was influenced by factors other than severity of esophagitis at entry and omeprazole dose. In phase 3 of the study the rate of endoscopic relapse was determined in 107 endoscopically healed patients after stopping omeprazole. Erosive or ulcerative esophagitis recurred in 88 of 107 (82%) by 6 mo. Neither initial dose, grade of esophagitis, nor smoking was shown to influence relapse rate. Omeprazole is a highly effective treatment for peptic esophagitis. The 40-mg/day dosage produces endoscopic healing slightly more quickly than the 20-mg/day dosage, and the initial endoscopic gradings are of prognostic value. Relapse occurs rapidly when treatment is stopped.
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                PubMed ID:: 12072599
                DOI:: 10.1097/00042737-200206000-00010

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