Randomised clinical trial: daily pantoprazole magnesium 40 mg vs. esomeprazole 40 mg for gastro-oesophageal reflux disease, assessed by endoscopy and symptoms

Abstract

SUMMARY BackgroundPantoprazole magnesium (pantoprazole-Mg) may display extended inhibition of the proton pump with the potential for improved clinical efficacy in gastro-oesophageal reflux disease (GERD).

Vonoprazan versus proton‐pump inhibitors for healing gastroesophageal reflux disease: A systematic review

“…3b). Data on healing rate at 4 weeks were reported in 39 trials from 38 studies, 14,16,30,[32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67] and the network for these comparisons was constructed with 18 treatments (vonoprazan, six PPIs, four H 2 RAs, and placebo) ( Fig. 3c).…”

“…For the sensitivity analyses, studies were excluded from the analysis as follows: one study 32 due to a high risk of bias from attrition, seven studies 35,38,39,45,48,65,68 that calculated healing rates based on PPS, and two studies 50,62 with only life table (or Kaplan-Meier) estimated healing rates. Only 20 studies (22 trials) 14,16,30,31,35,[37][38][39][40]42,43,[49][50][51]62,64,66,[68][69][70] used the Los Angeles scale for endoscopic assessment and were eligible for this analysis. The results (both estimates and orders) of these analyses were consistent with the main analysis, showing its robustness (Table S3).…”

Commentary: daily pantoprazole vs. esomeprazole for GERD – authors' reply

“…The authors' declarations of personal and financial interests are unchanged from those in the original article. 2 Høivik and colleagues 1 have recently published a retrospective analysis on the prevalence of anaemia in a population of newly diagnosed inflammatory bowel disease (IBD) patients including 756 patients (UC, n = 519 and CD, n = 237), comparing those data with the prevalence in the general population in Norway, which were followed up prospectively for 10 years. They found that 48.8% of Crohn's disease patients (CD) and 20.2% of ulcerative colitis (UC) patients were anaemic at diagnosis.…”

“…1,2 They mention that the detected superiority of pantoprazole-Mg over esomeprazole was marginal. We do not agree.…”

Commentary: daily pantoprazole vs. esomeprazole for GERD

“…1,2 Others have shown little difference in bioavailability and pharmacokinetics when assessed on the 7th day of dosing. 3 The study by Moraes-Filho et al compares a new pantoprazole magnesium compound with esomeprazole in patients with mostly mild (Los Angeles grade A 60%) gastro-oesophageal reflux disease (GERD). 4 There was little difference in terms of symptom relief as assessed by re QUEST-GI at 4 weeks and endoscopy, but when treatment was continued for a further 4 weeks in nonresponders a marginal superiority of pantoprazole magnesium was detected.…”