Comparison of the effects of omeprazole and famotidine in treatment of upper abdominal symptoms in patients with reflux esophagitis

Kusunoki, Hiroaki; Kusaka, Masayasu; Kido, Soichiro; Yamauchi, Ryo; Fujimura, Yoshinori; Watanabe, Yoshifumi; Kobori, Michio; Miwa, Hiroto; Tomita, Toshihiko; Kin, Yongmin; Hori, Keiichi; Tano, Nobuo; Sugimoto, Kenji; Nakamura, Yoshihiro; Fujimoto, Kazuma; Oza, Noriko; Matsunobu, Aki; Ono, Naofumi; Fuyuno, Seisuke; Kinoshita, Yoshikazu; Adachi, Kyoichi; Yuki, Mika; Fujisawa, Tomoo; Haruma, Ken

doi:10.1007/s00535-009-0003-4

Cited by 9 publications

(7 citation statements)

References 31 publications

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“…In the FSSG ≥8 group, GSRS abdominal pain and indigestion scores were lower at 8 and 24 weeks compared with at the baseline. These results are in line with the results of a previous study in which GSRS scores were evaluated after treatment with the H2 blocker famotidine and the PPI omeprazole ( 39 ). It was reported that the combination treatment significantly improved the acid reflux-associated symptoms as well as the scores for abdominal pain and indigestion ( 39 ).…”

Section: Discussionsupporting

confidence: 91%

“…These results are in line with the results of a previous study in which GSRS scores were evaluated after treatment with the H2 blocker famotidine and the PPI omeprazole ( 39 ). It was reported that the combination treatment significantly improved the acid reflux-associated symptoms as well as the scores for abdominal pain and indigestion ( 39 ). These findings suggest that treatment with acid secretion suppressors may improve QoL associated with gastrointestinal tract symptoms other than those affecting the esophagus.…”

Section: Discussionsupporting

confidence: 91%

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Efficacy of vonoprazan for 24-week maintenance therapy of patients with healed reflux esophagitis refractory to proton pump inhibitors

et al. 2017

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The aim of the present study was to evaluate the efficacy of a potassium-competitive acid blocker (P-CAB), vonoprazan, for the maintenance therapy of healed reflux esophagitis (RE). A total of 60 patients were enrolled in this open-label, single-center, prospective study. All patients were diagnosed with RE with a frequency scale for the symptoms of gastroesophageal reflux disease (FSSG) total score ≥8 following treatment with standard proton pump inhibitors (PPIs) for a minimum of 8 weeks. Standard PPI treatment was switched to vonoprazan 20 mg once daily for 4 weeks. A total of 52 patients, who had no endoscopic evidence of erosive esophagitis following vonoprazan treatment, received maintenance therapy with vonoprazan 10 mg once daily for 24 weeks. Symptoms were evaluated using the FSSG and Gastrointestinal Symptom Rating Scale (GSRS). Upper gastrointestinal endoscopies were performed following 24 weeks of maintenance therapy. The primary endpoint was to determine the proportion of patients who exhibited maintenance of healed RE refractory to PPIs following 24 weeks of maintenance therapy with vonoprazan 10 mg once daily. Secondary endpoints included evaluation of the proportion of patients with symptomatic non-relapse at 24 weeks. Maintenance therapy with vonoprazan 10 mg once daily prevented relapse of esophageal mucosal breaks in 37/43 (86.0%) patients at 24 weeks. However, the number of patients with symptomatic relapse was 1 (1.9%) and 4 (7.7%) at 4 and 8 weeks, respectively. A total of 4 patients were withdrawn due to loss to follow-up. At the end of the 24-week maintenance period, the symptomatic non-relapse rate for acid reflux-associated and dysmotility symptom FSSG scores were 86.5 and 80.8%, respectively. Furthermore, the symptomatic non-relapse rate for reflux, abdominal pain, indigestion, diarrhea, and constipation GSRS scores at 24 weeks were 86.5, 80.8, 75.0, 71.2 and 76.9%, respectively. No serious adverse events were reported during the study. The mean gastrin level was 1,059 pg/ml. In conclusion, the results of the present study indicate that vonoprazan 10 mg once daily is effective for 24-week maintenance therapy of healed RE refractory to PPIs.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 91%

Efficacy of vonoprazan for 24-week maintenance therapy of patients with healed reflux esophagitis refractory to proton pump inhibitors

et al. 2017

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“…The prevalence and severity of upper GI symptoms in J-FOCUS were comparable with those described in Japanese patients with GERD who had reflux esophagitis [10,23]. The mean number of upper GI symptoms per patient was 5.4 in the study by Adachi et al , which included patients with GERD who had reflux esophagitis, and a similarly high symptom load was observed in the CADET-PE study, in which 80% of patients with uninvestigated dyspepsia had at least six upper GI symptoms [10,11].…”

Section: Discussionsupporting

confidence: 58%

Efficacy of omeprazole, famotidine, mosapride and teprenone in patients with upper gastrointestinal symptoms: an omeprazole-controlled randomized study (J-FOCUS)

et al. 2012

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BackgroundIn Japan, treatment guidelines are lacking for patients with upper gastrointestinal symptoms. We aimed to compare the efficacy of different drugs for the treatment of uninvestigated upper gastrointestinal symptoms.MethodsThis was a randomized, open-label, parallel-group multicenter study. Helicobacter pylori-negative, endoscopically uninvestigated patients ≥ 20 years of age with upper gastrointestinal symptoms of at least moderate severity (Global Overall Symptom score [GOS] ≥ 4 on a 7-point Likert scale) were randomized to treatment with omeprazole (10 mg once daily), famotidine (10 mg twice daily), mosapride (5 mg three times daily) or teprenone (50 mg three times daily). The primary endpoint was sufficient relief of upper gastrointestinal symptoms after 4 weeks of treatment (GOS ≤ 2). UMIN clinical trial registration number: UMIN000005399.ResultsOf 471 randomized patients, 454 were included in the full analysis set. After 4 weeks of treatment, sufficient symptom relief was achieved by 66.9% of patients in the omeprazole group, compared with 41.0%, 36.3% and 32.3% in the famotidine, mosapride and teprenone groups, respectively (all, p < 0.001 vs omeprazole). There were no treatment-related adverse events.ConclusionsThe favorable efficacy and safety profiles of omeprazole in relieving uninvestigated upper gastrointestinal symptoms support its use as first-line treatment in this patient group in Japan. Patients who show no improvement in symptoms despite PPI use, and those with alarm symptoms (such as vomiting, GI bleeding or acute weight loss) should receive further investigation, including prompt referral for endoscopy.Trial registrationUMIN000005399.

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“…These results are in line with the results of a previous study that evaluated the GSRS scores after treatment with the H2 blocker, famotidine, and the PPI, OPZ. They reported that combination treatment significantly improved the acid refluxrelated symptoms as well as scores on abdominal pain and indigestion [49]. These findings suggest that treatment with acid secretion suppressors can improve QoL related to gastrointestinal tract symptoms other than those affecting the esophagus.…”

Section: Discussionmentioning

confidence: 91%

Efficacy of Vonoprazan for 48-Week Maintenance Therapy of Patients with Healed Reflux Esophagitis

Mizuno¹,

Nishino²,

Yamada³

et al. 2019

Digestion

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Aims: We aimed to evaluate the efficacy of vonoprazan (VPZ) as maintenance therapy for healed reflux esophagitis (RE). Methods: We enrolled 74 patients diagnosed with RE with frequency scale for the symptoms of gastroesophageal reflux disease (FSSG) total score ≥8 after at least 8 weeks of treatment with standard proton pump inhibitors (PPIs). These patients were switched to VPZ 20 mg for 4 weeks. We also enrolled 71 patients with no endoscopic evidence of erosive esophagitis who received maintenance therapy with VPZ 10 mg for 48 weeks. The primary end point was the proportion of patients who maintained healed RE refractory to PPIs after 48 weeks of maintenance therapy with on demand 10 mg VPZ. Secondary assessment included the proportion of patients with symptomatic nonrelapse at 48 weeks. Results: Fifty patients successfully completed 48-week maintenance therapy. Maintenance therapy with VPZ 10 mg prevented the relapse of esophageal mucosal breaks in 43 (86.0%) of 50 patients at 48 weeks. During the 48-week maintenance therapy, symptomatic nonrelapse rate for acid reflux-related symptom score of FSSG and acid reflux score of Gastrointestinal Symptom Rating Scale at 48 weeks were 70.0 and 72.0%, respectively. No serious adverse events were reported during the study. Conclusion: VPZ 10 mg is clinically effective for maintenance of healed RE for 48 weeks.

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Comparison of the effects of omeprazole and famotidine in treatment of upper abdominal symptoms in patients with reflux esophagitis

Cited by 9 publications

References 31 publications

Efficacy of vonoprazan for 24-week maintenance therapy of patients with healed reflux esophagitis refractory to proton pump inhibitors

Efficacy of vonoprazan for 24-week maintenance therapy of patients with healed reflux esophagitis refractory to proton pump inhibitors

Efficacy of omeprazole, famotidine, mosapride and teprenone in patients with upper gastrointestinal symptoms: an omeprazole-controlled randomized study (J-FOCUS)

Efficacy of Vonoprazan for 48-Week Maintenance Therapy of Patients with Healed Reflux Esophagitis

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