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临床试验:双重迟释技术的质子泵抑制剂多潘立酮 MR 可有效控制症状并预防愈合的糜烂性食管炎患者复发。

Clinical trial: dexlansoprazole MR, a proton pump inhibitor with dual delayed-release technology, effectively controls symptoms and prevents relapse in patients with healed erosive oesophagitis.

机构信息

University of Pennsylvania School of Medicine, Division of Gastroenterology, Philadelphia, PA, USA.

出版信息

Aliment Pharmacol Ther. 2009 Apr 1;29(7):742-54. doi: 10.1111/j.1365-2036.2009.03954.x. Epub 2009 Feb 7.

DOI:10.1111/j.1365-2036.2009.03954.x
PMID:19210298
Abstract

BACKGROUND

Dexlansoprazole MR heals all grades of erosive oesophagitis (EO).

AIM

To assess efficacy and safety of dexlansoprazole MR in maintaining healed EO and heartburn relief.

METHODS

In this randomized, double-blind trial, 445 patients with healed EO received dexlansoprazole MR 30 mg or 60 mg or placebo once daily for 6 months. This trial assessed maintenance of endoscopic healing (primary endpoint) and continued symptom relief based on daily diaries (secondary endpoints).

RESULTS

Dexlansoprazole MR 30 mg and 60 mg were superior to placebo for maintaining healed EO (P < 0.0025; Hochberg's). By life-table analysis, maintenance rates were 75%, 83% and 27% for dexlansoprazole MR 30 mg, 60 mg and placebo respectively. Crude maintenance rates were 66% for both dexlansoprazole MR doses and 14% for placebo. Dexlansoprazole MR controlled heartburn (medians of 91-96% for 24-h heartburn-free days, 96-99% for heartburn-free nights). The only more common adverse event occurring at a significantly higher rate in dexlansoprazole MR groups than placebo when analysed per patient-months of exposure was upper respiratory tract infection.

CONCLUSIONS

Dexlansoprazole MR effectively maintained EO healing and symptom relief; most patients were heartburn-free for >90% of days. Both doses were well tolerated.

摘要

背景

多廿烷醇可治愈所有等级的糜烂性食管炎(EO)。

目的

评估多廿烷醇治疗愈合的 EO 和缓解烧心的疗效和安全性。

方法

在这项随机、双盲试验中,445 例愈合的 EO 患者接受多廿烷醇 30mg 或 60mg 或安慰剂,每日 1 次,持续 6 个月。本试验评估内镜愈合的维持(主要终点)和基于每日日记的持续症状缓解(次要终点)。

结果

多廿烷醇 30mg 和 60mg 均优于安慰剂,可维持愈合的 EO(P < 0.0025; Hochberg)。通过寿命表分析,多廿烷醇 30mg、60mg 和安慰剂的维持率分别为 75%、83%和 27%。多廿烷醇 30mg 和 60mg 的粗维持率分别为 66%和 14%,安慰剂为 14%。多廿烷醇控制烧心(24 小时无烧心天数的中位数为 91-96%,无烧心夜数的中位数为 96-99%)。在按患者暴露月数分析时,多廿烷醇组唯一更常见且发生率显著高于安慰剂的不良事件是上呼吸道感染。

结论

多廿烷醇可有效维持 EO 愈合和症状缓解;大多数患者>90%的天数无烧心。两种剂量均具有良好的耐受性。

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