Röhss Kerstin, Hasselgren Göran, Hedenström Hans
AstraZeneca R&D Mölndal, Sweden.
Dig Dis Sci. 2002 May;47(5):954-8. doi: 10.1023/a:1015009300955.
Maintenance of intragastric pH > 4 is vital for effective management of gastroesophageal reflux disease (GERD). Esomeprazole 40 mg, the first proton pump inhibitor developed as an optical isomer, demonstrates improved acid inhibition over omeprazole 20 mg. Our aim was to compare esomeprazole 40 mg with omeprazole 40 mg, once-daily, on intragastric acidity in patients with symptoms of GERD. In this open-label, crossover study, 130 patients with symptoms of GERD received esomeprazole 40 mg or omeprazole 40 mg once-daily for five days. The 24-hr intragastric pH was monitored on days 1 and 5 of each treatment period. The mean percentage of the 24-hr period with intragastric pH > 4 was significantly greater (P < 0.001) with esomeprazole 40 mg than with omeprazole 40 mg on days 1 (48.6% vs 40.6%) and 5 (68.4% vs 62.0%). Interpatient variability was significantly less with esomeprazole than omeprazole. Esomeprazole was well tolerated. In conclusion, esomeprazole 40 mg provides more effective acid control than twice the standard dose of omeprazole.
维持胃内pH值> 4对于有效治疗胃食管反流病（GERD）至关重要。埃索美拉唑40毫克是首个作为光学异构体开发的质子泵抑制剂，其抑酸效果优于奥美拉唑20毫克。我们的目的是比较每日一次服用埃索美拉唑40毫克与奥美拉唑40毫克对GERD症状患者胃内酸度的影响。在这项开放标签的交叉研究中，130例有GERD症状的患者每日一次服用埃索美拉唑40毫克或奥美拉唑40毫克，持续五天。在每个治疗期的第1天和第5天监测24小时胃内pH值。在第1天（48.6%对40.6%）和第5天（68.4%对62.0%），服用埃索美拉唑40毫克的患者胃内pH值> 4的24小时时间段平均百分比显著高于服用奥美拉唑40毫克的患者（P < 0.001）。与奥美拉唑相比，埃索美拉唑的患者间变异性显著更小。埃索美拉唑耐受性良好。总之，40毫克埃索美拉唑比标准剂量两倍的奥美拉唑能提供更有效的胃酸控制。
