A randomized controlled pilot trial of two presentations of esomeprazol

Authors

  • Carlos Arturo Rojas Fundacion Valle del Lili
  • Mario Sepúlveda Copete Fundación Valle de Lili, Cali
  • Jairo Alberto García Abadía Fundación Valle de Lili, Cali
  • Héctor Raúl Echavarría Abad Fundación Valle de Lili
  • Fernando Rosso Suárez Fundación Valle de Lili
  • Andrés Fernando Jiménez Fundación Valle de Lili
  • Andrés Mauricio Castro Llanos Fundación Valle de Lili

DOI:

https://doi.org/10.22516/25007440.335

Keywords:

Esomeprazole, SODA, QoL-PEI, proton pump inhibitors, dyspepsia

Abstract

Introduction: This pilot studied the clinical effectiveness of two presentations of esomeprazole in patients with dyspepsia with undiagnosed causes.

Methods: We conducted a pilot clinical trial of two 40 mg Esomeprazole presentations. Patients with dyspepsia of unknown cause at a gastroenterology clinic in a referral hospital were included. They received one or the other presentation daily for 28 days. Patients were initially evaluated with endoscopy and biopsy and received follow-up examinations at two and four weeks. Adverse events were recorded, and clinical symptom scales and quality of life questionnaires validated in Spanish (SODA and QoL-PEI) were used. In addition, gastric pH levels were measured continuously for 24 hours on day 14 of treatment. Serum levels of the medication administered were also measured on day 14 of treatment. A two-way repeated measures ANOVA was used to compare mean differences between the two groups. When significant differences in times were found, a Bonferroni correction was made.

Results: A total of 33 patients were randomized into two groups: 16 patients in one group and 17 in the other. There were no differences in the percentages of gastric pH inhibition at day 14 of treatment (p = 0.9795). There were no differences in serum level concentrations on day 14 (p = 0.2199). No significant differences were found in severity and quality of life scales in the first two weeks of treatment. However, in the last two weeks of treatment the test product showed a larger decrease in pain (p = 0.0048) and superiority in compliance (p = 0.01) on the SODA subscale. There were no serious adverse events, and there were no statistical differences between the presentations of non-serious adverse events.

Conclusions: The Test product and the Reference product showed similar effects on clinically relevant variables.

Downloads

Download data is not yet available.

Author Biographies

Carlos Arturo Rojas, Fundacion Valle del Lili

Médico internista, Gastroenterólogo, Unidad de endoscopia, Fundación Valle del Lili, Cali, Colombia

Mario Sepúlveda Copete, Fundación Valle de Lili, Cali

Médico internista, Gastroenterólogo, Unidad de endoscopia, Fundación Valle del Lili, Cali, Colombia

Jairo Alberto García Abadía, Fundación Valle de Lili, Cali

Médico internista, Gastroenterólogo, Unidad de endoscopia, Fundación Valle del Lili, Cali, Colombia

Héctor Raúl Echavarría Abad, Fundación Valle de Lili

Médico Cirujano, Gastroenterólogo, Unidad de Endoscopia, Fundación Valle del Lili, Cali, Colombia

Fernando Rosso Suárez, Fundación Valle de Lili

Director Centro de investigaciones clínicas, Médico internista, infectólogo, epidemiólogo, Fundación Valle del Lili, Cali, Colombia

Andrés Fernando Jiménez, Fundación Valle de Lili

Coordinador Estudios clínicos, Centro de investigaciones clínicas, Fundación Valle del Lili, Cali, Colombia

Andrés Mauricio Castro Llanos, Fundación Valle de Lili

Estadístico, Centro de investigaciones clínicas, Fundación Valle del Lili, Cali, Colombia

References

Talley NJ, Vakil N. Guidelines for the management of dyspepsia. Am J Gastroenterol. 2005;100(10):2324-37. https://doi.org/10.1111/j.1572-0241.2005.00225.x.

Stanghellini V, Chan FK, Hasler WL, Malagelada JR, Suzuki H, Tack J, et al. Gastroduodenal disorders. Gastroenterology. 2016;150(6):1380-92. https://doi.org/10.1053/j.gastro.2016.02.011.

Talley NJ. Functional dyspepsia: new insights into pathogenesis and therapy. Korean J Intern Med. 2016;31(3):444-56. https://doi.org/10.3904/kjim.2016.091.

Bravo LE, Cortés A, Carrascal E, Jaramillo R, García LS, Bravo PE, et al. Helicobacter pylori: patología y prevalencia en biopsias gástricas en Colombia. Colomb Med. 2003;34(3):124-31.

Otero W, Zuleta MG, Otero L. Enfoque del paciente con dispepsia y dispepsia funcional: actualización. Rev Col Gastroenterol. 2014;29(2):132-8.

Shin JM, Kim N. Pharmacokinetics and pharmacodynamics of the proton pump inhibitors. J Neurogastroenterol Motil. 2013;19(1):25-35. https://doi.org/10.5056/jnm.2013.19.1.25.

Hatlebakk JG. Review article: gastric acidity − comparison of esomeprazole with other proton pump inhibitors. Alimentary Pharmacology & Therapeutics. 2003;17:10-5. https://doi.org/10.1046/j.1365-2036.17.s1.3.x.

Kirchheiner J, Glatt S, Fuhr U, Klotz U, Meineke I, Seufferlein T, et al. Relative potency of proton-pump inhibitors-comparison of effects on intragastric pH. Eur J Clin Pharmacol. 2009;65(1):19-31. https://doi.org/10.1007/s00228-008-0576-5.

Ruiz M, Villasante F, León F, González-Lara V, González C, Crespo M, et al. Cuestionario sobre calidad de vida asociada a dispepsia. Adaptación española y validación del cuestionario Dyspepsia Related Health Scale. Medicina Clínica. 2001;117(15):567-73. https://doi.org/10.1016/S0025-7753(01)72182-3.

Benites Goñi H, Cabrera Cabrejos S, Chungui Bravo J, Prochazka Zarate R, Bernabe Ortiz A, De los Ríos Senmache R, et al. Modificación y validación del instrumento SODA (severity of dyspepsia assessment) adaptada al Perú para evaluar la evolución de la severidad de los síntomas en pacientes con dispepsia. Rev Gastroenterol Perú. 2013;33(1):9-27.

Rabeneck L, Cook KF, Wristers K, Souchek J, Menke T, Wray NP. SODA (severity of dyspepsia assessment): a new effective outcome measure for dyspepsia-related health. Journal of clinical epidemiology. 2001;54(8):755-65. https://doi.org/10.1016/S0895-4356(00)00365-6.

Randomization.com. [internet] 2007 [acceso el 15 de marzo de 2017]. Disponible en: http://www.randomization.com/2007.

Moher D, Hopewell S, Schulz KF, Montori V, Gøtzsche PC, Devereaux PJ, et al. CONSORT 2010 Explanation and Elaboration: updated guidelines for reporting parallel group randomised trials. BMJ. 2010;340:c869. https://doi.org/10.1136/bmj.c869.

Ullah MA, Shams Ud D, Maruf AA, Azad MAK, Shohag MH, Sultana R, et al. Relative bioavailability and pharmacokinetic properties of two different enteric formulations of esomeprazole in healthy bangladeshi male volunteers: An open-label, single-dose, randomized-sequence, two-way crossover study. Clinical Therapeutics. 2010;32(7):1419-26. https://doi.org/10.1016/j.clinthera.2010.07.007.

Shin JS, Lee JY, Cho KH, Park HL, Kukulka M, Wu JT, et al. The pharmacokinetics, pharmacodynamics and safety of oral doses of ilaprazole 10, 20 and 40 mg and esomeprazole 40 mg in healthy subjects: a randomised, open-label crossover study. Alimentary Pharmacology & Therapeutics. 2014;40(5):548-61. https://doi.org/10.1111/apt.12860

Furuta T, Ohashi K, Kosuge K, Zhao XJ, Takashima M, Kimura M, et al. CYP2C19 genotype status and effect of omeprazole on intragastric pH in humans. Clinical Pharmacology & Therapeutics. 1999;65(5):552-61. https://doi.org/10.1016/S0009-9236(99)70075-5

Hunfeld NG, Touw DJ, Mathot RA, van Schaik RH, Kuipers EJ. A comparison of the acid-inhibitory effects of esomeprazole and rabeprazole in relation to pharmacokinetics and CYP2C19 polymorphism. Alimentary Pharmacology & Therapeutics. 2012;35(7):810-8. https://doi.org/10.1111/j.1365-2036.2012.05014.x.

Klotz U. Impact of CYP2C19 polymorphisms on the clinical action of proton pump inhibitors (PPIs). Eur J Clin Pharmacol. 2009;65(1):1-2. https://doi.org/10.1007/s00228-008-0571-x

Dean L. Esomeprazole Therapy and CYP2C19 Genotype. 2012 [updated 2016 Mar 8]. In: Pratt V, McLeod H, Rubinstein W, Dean L, Kattman B, Malheiro A, editors. Medical Genetics Summaries [Internet]. Bethesda (MD): National Center for Biotechnology Information (US); 2012-. Available from http://www.ncbi.nlm.nih.gov/books/NBK100896/.

Lou H-Y, Chang C-C, Sheu M-T, Chen Y-C, Ho H-O. Optimal dose regimens of esomeprazole for gastric acid suppression with minimal influence of the CYP2C19 polymorphism. Eur J Clin Pharmacol. 2008;65(1):55-64. https://doi.org/10.1007/s00228-008-0552-0.

Menéndez JLT. Farmacología de esomeprazol. Emergencias: Revista de la Sociedad Española de Medicina de Urgencias y Emergencias. 2005;17(4):1059-66.

Mahadeva S, Goh KL. Epidemiology of functional dyspepsia: a global perspective. World J Gastroenterol. 2006;12(17):2661-6. https://doi.org/10.3748/wjg.v12.i17.2661.

Talley NJ, Vakil NB, Moayyedi P. American gastroenterological association technical review on the evaluation of dyspepsia. Gastroenterology. 2005;129(5):1756-80. https://doi.org/10.1053/j.gastro.2005.09.020.

Published

2019-10-07

How to Cite

Rojas, C. A., Sepúlveda Copete, M., García Abadía, J. A., Echavarría Abad, H. R., Rosso Suárez, F., Jiménez, A. F., & Castro Llanos, A. M. (2019). A randomized controlled pilot trial of two presentations of esomeprazol. Revista Colombiana De Gastroenterología, 34(3), 261–268. https://doi.org/10.22516/25007440.335

Issue

Section

Originals articles

Altmetric

Article metrics
Abstract views
Galley vies
PDF Views
HTML views
Other views
QR Code