Monitoring the growing use of esomeprazole

Thompson, Angus

doi:10.1002/psb.1757

Cited by 3 publications

(1 citation statement)

References 8 publications

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“…Esomeprazole is the most frequently prescribed proton-pump inhibitor in human medicine. 11 The S-enantiomer of omeprazole is four times more potent than the R-enantiomer 12 with further work demonstrating that esomeprazole results in more pronounced and consistent acid-suppressive effects compared to omeprazole in humans. 13,14 Area under the curve (AUC) is considered the most important pharmacokinetic determinant of efficacy for proton-pump inhibitors in humans and horses, 15 with a higher AUC expected to be associated with improved outcomes.…”

Section: Introductionmentioning

confidence: 96%

Comparison of oral esomeprazole and oral omeprazole in the treatment of equine squamous gastric disease

Sundra,

Gough,

Rossi

et al. 2023

Equine Veterinary Journal

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BackgroundOral omeprazole is the accepted treatment for equine squamous gastric disease (ESGD); however, it is not universally effective. Esomeprazole results in more consistent and pronounced acid suppression in men and is more effective than omeprazole in the treatment of oesophageal and gastric disease. Pharmacodynamic and pilot clinical studies have indicated esomeprazole might also be more effective than omeprazole in horses.ObjectivesTo compare the efficacy and safety of oral esomeprazole and omeprazole pastes in the treatment of ESGD and, where present, concurrent equine glandular gastric disease (EGGD).Study designRandomised, single‐blinded controlled trial.MethodsHorses presenting with grade ≥2 ESGD lesions were randomly allocated to receive 4 mg/kg of either a buffered esomeprazole or omeprazole paste orally once daily for 28 days before gastroscopy being repeated within a further 3 days. Videos and images were anonymised and subsequently graded blind by one researcher. The severity of ESGD (and EGGD) lesions before and after treatment, and thereby treatment responses, were compared using univariable logistic regression.ResultsA higher proportion of horses had ESGD healing in response to esomeprazole treatment (63/74, 85%) than with omeprazole treatment (43/73, 59%) (odds ratio [OR]: 4.00, 95% confidence interval [CI]: 1.81, 8.82, p = 0.001). In a subset of horses that had concurrent EGGD, a greater proportion of the horses treated with esomeprazole had lesions ≤grade 1 (esomeprazole 28/51, 55%; omeprazole 6/24, 25%; OR: 3.65, 95% CI: 1.25, 10.71, p = 0.02) Using grade 0 as the benchmark for EGGD healing, the difference remained significant (OR: 4.44, 95% CI: 1.33, 14.85, p = 0.02).Main limitationsIt may not be possible to extrapolate these results to other populations with different signalment or management.ConclusionsOral‐buffered esomeprazole was a more effective treatment for ESGD (and concurrent EGGD) than oral‐buffered omeprazole.

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Section: Introductionmentioning

confidence: 96%

Comparison of oral esomeprazole and oral omeprazole in the treatment of equine squamous gastric disease

Sundra,

Gough,

Rossi

et al. 2023

Equine Veterinary Journal

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Pharmaceutical treatment of equine glandular gastric disease: A contextualised review of recent developments

Rendle,

Gough

2024

Equine Veterinary Education

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SummaryRecent studies report the use of a range of treatments for equine glandular gastric disease, but with all treatments, refractory disease is common. The evidence for some widely used treatments is very poor. Treatments may aim to suppress acid production (e.g. omeprazole), promote mucosal barrier function (e.g. misoprostol/sucralfate), or both. It is imperative that all treatments are combined with management to minimise known risk factors, primarily physiological and psychological stressors.

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Esomeprazole in the treatment of equine glandular gastric disease

Sundra¹

2021

UK-Vet Equine

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Background: Equine glandular gastric disease is a highly prevalent disease, for which there is no universally effective treatment. Given the widespread use of esomeprazole in the treatment of peptic ulcer disease in humans, its use in horses warrants further investigation. Objective: To assess rates of healing of equine glandular gastric disease using oral esomeprazole. Study design: Retrospective case series. Methods: Medical records and gastroscopy images of horses diagnosed with equine glandular gastric disease and treated with esomeprazole by Avon Ridge Equine Veterinary Services were reviewed. Results: Out of four horses treated with esomeprazole for 28 days, 75% (three) healed and 25% (one) did not improve. Out of three horses treated with esomeprazole for 14 days, 67% (two) healed and 33% (one) did not improve. Main limitations: The study was limited by its retrospective nature and small sample size. Conclusions: Esomeprazole may be a valid first-line treatment option for equine glandular gastric disease. Larger and more robust studies of esomeprazole are warranted.

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Monitoring the growing use of esomeprazole

Cited by 3 publications

References 8 publications

Comparison of oral esomeprazole and oral omeprazole in the treatment of equine squamous gastric disease

Comparison of oral esomeprazole and oral omeprazole in the treatment of equine squamous gastric disease

Pharmaceutical treatment of equine glandular gastric disease: A contextualised review of recent developments

Esomeprazole in the treatment of equine glandular gastric disease

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