The effects of dose and timing of esomeprazole administration on 24‐h, daytime and night‐time acid inhibition in healthy volunteers

Wilder‐Smith, Clive H.; Röhss, Kerstin; Singh, Sunita; Sagar, Mohamed; Nagy, Péter

doi:10.1111/j.1365-2036.2010.04469.x

Cited by 36 publications

(29 citation statements)

References 15 publications

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“…Esomeprazole 20 mg twice-daily (split dose) resulted in 76.5 % intragastric pH > 4 over 24 h as compared with esomeprazole 40 mg daily ( AM ), which resulted in only 68.8 % intragastric pH > 4 over 24 h. Th e eff ect of the split dose was most notable during nighttime intragastric pH assessment as compared with a one-time dose (62.8 vs. 51.4 % respectively). Unlike the current study by Kinoshita et al ( 8 ), Wilder-Smith et al ( 12 ) demonstrated a dose-response eff ect of esomeprazole on intragastric pH. In their study, esomeprazole 40 mg twice-daily in a split dose provided the most effi cacious eff ect on % 24-h and nighttime intragastric pH > 4 (87.1 and 81 % , respectively).…”

Section: Th E Introduction Of the Proton Pump Inhibitor (Ppi) Class Ocontrasting

confidence: 88%

“…In a study by Wilder-Smith et al ( 12 ), the authors evaluated the eff ect of diff erent esomeprazole regimens on 24-h intragastric pH. Esomeprazole 20 mg twice-daily (split dose) resulted in 76.5 % intragastric pH > 4 over 24 h as compared with esomeprazole 40 mg daily ( AM ), which resulted in only 68.8 % intragastric pH > 4 over 24 h. Th e eff ect of the split dose was most notable during nighttime intragastric pH assessment as compared with a one-time dose (62.8 vs. 51.4 % respectively).…”

Section: Th E Introduction Of the Proton Pump Inhibitor (Ppi) Class Omentioning

confidence: 98%

See 1 more Smart Citation

Editorial: Healing Erosive Esophagitis With a Proton Pump Inhibitor: The More the Merrier?

Fass

2012

American Journal of Gastroenterology

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Patients with erosive esophagitis (EE) account for 30 % of patients with gastroesophageal refl ux disease; only a minority of these patients fail to achieve healing on treatment with a proton pump inhibitor (PPI), once-daily, for 8 weeks. For those patients with EE who have failed to heal on a PPI, given once-daily, current practice is to double the PPI dose although there is little published evidence to support this. In this issue of the American Journal of Gastroenterology , authors from Japan have demonstrated that double-dose PPI produced higher healing rates when given as a split, twicedaily dose than as a once-daily dose for patients with EE who had failed initial therapy with rabeprazole 10 mg once-daily. Quadruple-dose PPI, given as a split dose, did not increase the healing rates but did produce better symptom control, albeit limited, compared with double-dose PPI, given twice-daily. Because subjects, initially, received a lower PPI dose than that generally indicated for EE (rabeprazole 20 mg daily), this study does not provide the eagerly awaited justifi cation for double-dose PPI therapy in patients with EE who have failed standard-dose PPI once-daily. However, it does demonstrate the clinical advantage of a split-dose regimen ( AM and PM ), compared with a once-daily regimen, when doubling the dose of a PPI for patients with residual EE after initial therapy. Am J Gastroenterol 2012; 107:531 -533; doi: 10.1038/ajg.2012 Th e introduction of the proton pump inhibitor (PPI) class of drugs has revolutionized treatment of erosive esophagitis (EE).Patients with EE receiving standard-dose PPI demonstrated 85 -96 % healing rates regardless of PPI brand and disease severity ( 1,2 ). However, despite the success of PPIs in healing EE, several areas of unmet need commonly result in PPI dose adjustments by practicing physicians. Patients with moderateto-severe EE (Los Angeles grades C and D) are less responsive to standard-dose PPI compared with patients with mild EE (Los Angeles grades A and B). One study demonstrated the following failure rates for subjects taking either omeprazole 20 mg once-daily or esomeprazole 40 mg once-daily: 9.6 and 6.6 % for Los Angeles grade A, 28.7 and 10.6 % for grade B, 29.6 and 12.8 % for grade C, and 36.2 and 20 % for grade D, respectively ( 3 ). In addition, the symptom resolution rate for those with EE receiving standard-dose PPI was 10 -15 % lower than the esophageal mucosal healing rate ( 4 ). Th e latter suggests that subjects with EE receiving PPI once-daily may continue to have GERD (gastroesophageal refl ux disease)-related symptoms despite complete esophageal healing. More disconcerting is that 10.2 -28.8 % of subjects with grades A and B and 15.9 -41.2 % with grades C and D experienced relapse within 6 months on maintenance with the same PPI dose (once-daily) that healed their EE initially ( 5 ). Consequently, it has become common practice to double the PPI dose in patients with EE who demonstrate partial or complete lack of response to standard-dose PPI. Howe...

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Section: Th E Introduction Of the Proton Pump Inhibitor (Ppi) Class Ocontrasting

confidence: 88%

Section: Th E Introduction Of the Proton Pump Inhibitor (Ppi) Class Omentioning

confidence: 98%

Editorial: Healing Erosive Esophagitis With a Proton Pump Inhibitor: The More the Merrier?

Fass

2012

American Journal of Gastroenterology

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“…Using PPI before dinner rather than before breakfast might have more effectively controlled the reflux‐related awakenings during sleep. It has been shown that a PPI used before dinner provided better control of nGER than did the same PPI when used before breakfast . Nighttime symptoms, daytime sleepiness, and poorer sleep quality were significantly related to refractory GERD symptoms.…”

Section: Role Of Nocturnal Reflux Symptoms In Sleep Disordersmentioning

confidence: 99%

Gastroesophageal reflux disease: recent advances and its association with sleep

2016

Annals of the New York Academy of Sciences

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Gastroesophageal reflux disease (GERD) is prevalent in Asia as well as in Western countries. Sleep disturbance and breathing disorders during sleep are becoming increasingly prevalent, and they are commonly associated with GERD. The relationship between GERD and obstructive sleep apnea (OSA) is still questionable, and it has expanded to include Barrett's esophagus. Nocturnal gastroesophageal reflux (nGER) symptoms might be clinically important in the explanation of this association. The therapy for reflux symptoms has resulted in improved subjective sleep parameters and enhanced sleep quality, thus supporting a direct relationship between GERD and sleep disturbance. This review discusses the epidemiology of sleep disturbances in GERD patients; the causative relationship between GERD and OSA, even though it remains an area of controversy; and the possible role of nGER in sleep problems. It also provides an update on the current state of knowledge linking GERD and sleep.

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“…The impact on esophageal acid exposure during sleep may have been greater if esomeprazole had been given before dinner. It has been shown that a PPI given in the evening before dinner provides better control of nighttime reflux, as compared to the same PPI given in the morning before breakfast …”

Section: Discussionmentioning

confidence: 99%

The effect of antireflux treatment on the frequency of awakenings from sleep in patients with Gastroesophageal reflux disease

Jha

Maradey–Romero

Gadam

et al. 2014

Neurogastroenterology Motil

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The effects of dose and timing of esomeprazole administration on 24‐h, daytime and night‐time acid inhibition in healthy volunteers

Abstract: SUMMARY BackgroundSymptoms of gastro-oesophageal reflux disease (GERD) may persist despite daily treatment with a proton pump inhibitor (PPI).

Cited by 36 publications

References 15 publications

Editorial: Healing Erosive Esophagitis With a Proton Pump Inhibitor: The More the Merrier?

Editorial: Healing Erosive Esophagitis With a Proton Pump Inhibitor: The More the Merrier?

Gastroesophageal reflux disease: recent advances and its association with sleep

The effect of antireflux treatment on the frequency of awakenings from sleep in patients with Gastroesophageal reflux disease

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