Intravenous Pantoprazole as Initial Treatment in Patients With Gastroesophageal Reflux Disease and a History of Erosive Esophagitis: A Randomized Clinical Trial

Abstract

We sought to evaluate safety and efficacy of IV pantoprazole when used as initial therapy in patients with gastroesophageal reflux disease (GERD) and a history of erosive esophagitis (EE) in a double-blind, placebo-controlled, randomized, parallel-group study. Patients were randomized to 7 days of once-daily IV or oral pantoprazole (40 mg) or placebo. Efficacy variables included maximal acid output, basal acid output, and changes from baseline in frequency/severity of GERD symptoms, and frequency of antacid usage. Seventy-eight patients were randomized (n=26/27/25 [IV/oral/placebo]). Mean maximal acid output was 8.4, 6.3, and 20.9 mEq/h for IV or oral pantoprazole, and placebo, respectively. For pantoprazole versus placebo, maximal and basal acid output were significantly lower (P<.001) and there was a numerical trend toward improved GERD and antacid usage. Both treatments were well tolerated. In conclusion, IV/oral pantoprazole were similarly effective in suppressing basal and pentagastrin-stimulated gastric acid secretion in GERD patients with a history of EE.

A Pilot Study of Efficacy and Safety of Continuous Intravenous Infusion of Pantoprazole in the Treatment of Severe Erosive Esophagitis

“…Previous studies on intravenous infusion of pantoprazole have demonstrated its efficacy and safety in treating GERD [13], erosive esophagitis [14,15], Zollinger-Ellison syndrome [10], and acute gastrointestinal bleeding [11,12]. To our knowledge, our study is the first to show that intravenous infusion of pantoprazole, including infusion once a day or continuous infusion for 72 h, in treating severe esophagitis was efficient and safe.…”

“…In addition, intravenous infusion produces a faster and steadier acid suppression than an does the oral regimen [10][11][12]. The safety of intravenous pantoprazole has been demonstrated in patients with GERD [13], with erosive esophagitis [14,15], with Zollinger-Ellison syndrome [10], or with bleeding ulcer [11,12].…”

Latin American Consensus on Gastroesophageal Reflux Disease: An Update on Therapy

“…Review outcome: The only study 39 comparing a PPI with placebo in patients with erosive esophagitis used intravenous pantoprazole and did not evaluate any of the clinical outcomes specified in this analysis. No studies comparing PPIs with H 2 -RAs or prokinetics for the healing of erosive esophagitis were published during the review period.…”

An update on the use of pantoprazole as a treatment for gastroesophageal reflux disease

“…Powered by TCPDF (www.tcpdf.org) pantoprazole include headache, nausea, dizziness, flushing, and pain at the site of injection; however, data on tolerability in this subset of patients are limited. 53 Randomized, controlled, double-blind control trials in patients with GERD have shown that oral pantoprazole 40 mg/day has a comparable tolerability profile to oral omeprazole 20 mg/day and lansoprazole 30 mg/day after 8 weeks of therapy. 54,55 In addition, oral pantoprazole 40 mg/day has similar tolerability comparing to H2RAs, such as ranitidine 300 mg/day and famotidine 40 mg/day.…”