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雷贝拉唑治疗儿童(1-11 岁)胃食管反流病的疗效和安全性。

Efficacy and safety of rabeprazole in children (1-11 years) with gastroesophageal reflux disease.

机构信息

*Pediatric & Adolescent Gastroenterology & Nutrition, Youngstown, OH †Children's Memorial Health Institute, Warsaw, Poland ‡Geisinger Medical Center Clinic, Wilkes Barre, PA §Gastrointestinal Associates, Jackson, MS ||Janssen Research & Development, LLC, Titusville, NJ.

出版信息

J Pediatr Gastroenterol Nutr. 2013 Dec;57(6):798-807. doi: 10.1097/MPG.0b013e3182a4e718.

Abstract

OBJECTIVE

Evaluate the efficacy and safety of rabeprazole in children, 1 to 11 years old, with endoscopically/histologically proven gastroesophageal reflux disease (GERD).

METHODS

Children were randomized to 0.5- or 1.0-mg/kg rabeprazole granule formulation for 12 weeks. The dose was further determined by weight: children 6 to 14.9 kg (low-weight cohort) received 5 or 10 mg and children ≥15 kg (high-weight cohort) received 10 or 20 mg. The primary endpoint was endoscopic/histologic healing at week 12 (defined as grade 0 on the Hetzel-Dent classification scale and/or grade 0 on the Histological Features of Reflux Esophagitis scale).

RESULTS

Overall, 81% (87/108) achieved endoscopic/histologic healing at week 12 with higher healing in the low-weight cohort (82% [5-mg dose], 94% [10-mg dose]) compared with high-weight cohort (76% [10-mg dose], 78% [20-mg dose]). There was a significant (P < 0.001) decrease in the mean Total GERD Symptoms and Severity score from 19.7 points (baseline) to 8.6 points (week 12), with 26% fewer children reporting GERD symptoms at week 12. The average frequency of symptoms per child decreased from 7.7 (week 1) to 4.7 (week 12). The GERD Symptom Relief score showed that 71% of children felt better, 81% were rated "good to excellent" on the Global Treatment Satisfaction scale by the investigator; 77% were rated "good to excellent" on the Clinical Global Impressions-Improvement scale by the parent/caregiver. The most common (>10%) treatment-emergent adverse events included cough and vomiting (14% each), abdominal pain (12%), and diarrhea (11%).

CONCLUSIONS

Rabeprazole was effective and safe in 1- to 11-year-old children with GERD.

摘要

目的

评估雷贝拉唑在 1 至 11 岁经内镜和组织学证实的胃食管反流病(GERD)患儿中的疗效和安全性。

方法

患儿随机分为 0.5 或 1.0mg/kg 的雷贝拉唑颗粒制剂,治疗 12 周。剂量进一步根据体重确定:6 至 14.9kg 的患儿(低体重组)给予 5 或 10mg,≥15kg 的患儿(高体重组)给予 10 或 20mg。主要终点为第 12 周的内镜/组织学愈合(Hetzel-Dent 分类量表评分为 0 级和/或反流性食管炎组织学特征量表评分为 0 级)。

结果

总体而言,108 例患儿中有 81%(87/108)在第 12 周达到内镜/组织学愈合,低体重组的愈合率更高(5mg 剂量组 82%,10mg 剂量组 94%),而高体重组的愈合率较低(10mg 剂量组 76%,20mg 剂量组 78%)。总 GERD 症状和严重程度评分从 19.7 分(基线)显著下降至 8.6 分(第 12 周)(P<0.001),第 12 周时报告 GERD 症状的患儿比例减少了 26%。每个患儿的平均症状频率从第 1 周的 7.7 次减少至第 12 周的 4.7 次。GERD 症状缓解评分显示,71%的患儿感觉更好,81%的患儿研究者评估的总体治疗满意度评分“好到极好”;77%的患儿父母/照护者评估的临床总体印象-改善评分“好到极好”。最常见(>10%)的治疗相关不良事件包括咳嗽和呕吐(各 14%)、腹痛(12%)和腹泻(11%)。

结论

雷贝拉唑治疗 1 至 11 岁 GERD 患儿有效且安全。

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