Barradell L B, Faulds D, McTavish D
Adis International Limited, Auckland, New Zealand.
Drugs. 1992 Aug;44(2):225-50. doi: 10.2165/00003495-199244020-00007.
Lansoprazole is an effective acid pump inhibitor acting at the final enzymatic step of the acid secretory pathway of the parietal cell, decreasing gastric acid secretion regardless of the primary stimulus. Results of short term (less than 8 weeks) clinical trials have shown lansoprazole to be significantly superior to placebo and ranitidine in the treatment of duodenal ulcer, both in the rate of healing and in overall healing at 4 weeks. Lansoprazole appears to heal duodenal ulcer more quickly than famotidine, and demonstrates slightly greater efficacy at 4 weeks, although both drugs appear to have equivalent efficacy overall. Gastric ulcers and reflux oesophagitis are also healed by lansoprazole 30 mg/day for 4 to 8 weeks, with healing rates after 8 weeks of approximately 85 to 95% for both indications. Lansoprazole appears to be superior to ranitidine and comparable to omeprazole in treating reflux oesophagitis. Furthermore, lansoprazole has relieved reflux symptoms more quickly than either ranitidine or omeprazole. Preliminary data also indicate that lansoprazole may be effective in the treatment of peptic ulcer disease and reflux oesophagitis refractory to H2-receptor antagonists, and in patients with Zollinger-Ellison syndrome. While direct comparisons with omeprazole are limited, results suggest that lansoprazole, used for short term treatment, is at least as effective as omeprazole in the treatment of peptic ulcer and reflux oesphagitis. Lansoprazole has been well tolerated in short term clinical trials, with an incidence of adverse effects comparable with that of other agents in its therapeutic class. Trials assessing long term tolerability data are ongoing and will be required as part of the assessment of the safety profile, if lansoprazole is to be used prophylactically to prevent ulcer recurrence. Thus, by virtue of its ability to heal ulcers and rapidly relieve associated symptomatology, lansoprazole represents a useful alternative for the treatment of acid related disorders.
兰索拉唑是一种有效的酸泵抑制剂，作用于壁细胞酸分泌途径的最后一个酶促步骤，无论主要刺激因素如何，均可减少胃酸分泌。短期（少于8周）临床试验结果表明，在十二指肠溃疡的治疗中，兰索拉唑在愈合率和4周时的总体愈合情况方面均显著优于安慰剂和雷尼替丁。兰索拉唑似乎比法莫替丁能更快地治愈十二指肠溃疡，并且在4周时显示出稍高的疗效，尽管两种药物总体疗效似乎相当。胃溃疡和反流性食管炎通过每天30毫克兰索拉唑治疗4至8周也可愈合，两种适应症在8周后的愈合率约为85%至95%。在治疗反流性食管炎方面，兰索拉唑似乎优于雷尼替丁，与奥美拉唑相当。此外，兰索拉唑比雷尼替丁或奥美拉唑更快地缓解反流症状。初步数据还表明，兰索拉唑可能对治疗H2受体拮抗剂难治的消化性溃疡疾病和反流性食管炎以及卓-艾综合征患者有效。虽然与奥美拉唑的直接比较有限，但结果表明，用于短期治疗时，兰索拉唑在治疗消化性溃疡和反流性食管炎方面至少与奥美拉唑一样有效。在短期临床试验中，兰索拉唑耐受性良好，不良反应发生率与治疗类别中的其他药物相当。评估长期耐受性数据的试验正在进行，如果要预防性使用兰索拉唑以预防溃疡复发，这些数据将作为安全性评估的一部分。因此，凭借其治愈溃疡和迅速缓解相关症状的能力，兰索拉唑是治疗酸相关疾病的一种有用的替代药物。
