Esomeprazole more effective than lansoprazole in erosive oesophagitis
Esomeprazole (Nexium) is more effective than lansoprazole
at healing erosive oesophagitis, a new study shows. The study, which was
funded by AstraZeneca, was presented this week at the United European
Gastroenterology Week in Amsterdam.
Professor David Johnson, Eastern Virginia School
of Medicine, United States, and colleagues randomly assigned 5,241 patients
with endoscopically diagnosed erosive oesophagitis to receive either esomeprazole
40mg or lansoprazole 30mg daily for eight weeks.
The researchers say that healing rates were higher
with esomeprazole than with lansoprazole at both four weeks and eight
weeks of treatment, and were more pronounced in those with more severe
disease at baseline. Onset of sustained resolution of heartburn occurred
a day earlier in the group treated with esomeprazole compared with the
lansoprazole group (seven days versus eight days P<=0.01).
Commenting on the study, Professor Johnson says:
“Previous clinical data have shown that esomeprazole 40mg heals more patients
with reflux oesophagitis at four and eight weeks than omeprazole 20mg.
In addition, this study now confirms esomeprazole’s superiority over lansoprazole
for faster onset of sustained symptom resolution, which is especially
important for patients requiring therapy before a clinical diagnosis by
endoscopy can be determined.”
In a statement released on October 9, Wyeth, the
company responsible for marketing lansoprazole (Zoton), comments that
the number of patients recruited into the trial was up to 10 times the
number usually seen in comparative trials of proton pump inhibitors. This
led to the improvement in healing rates being statistically significant
but not clinically significant. “We would not expect this slight increase
in healing rates to translate into an improvement in patient care,” the
company says.
The company adds that fast symptomatic relief is
the primary objective for patients and lansoprazole achieves symptomatic
relief from day one.
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