Takenaka Ryuta, Okada Hiroyuki, Kawano Seiji, Komazawa Yoshinori, Yoshinaga Fumiya, Nagata Shinji, Inoue Masafumi, Komatsu Hirohisa, Onogawa Seiji, Kushiyama Yoshinori, Mukai Shinichi, Todo Hiroko, Okanobu Hideharu, Manabe Noriaki, Tanaka Shinji, Haruma Ken, Kinoshita Yoshikazu
Ryuta Takenaka, Department of Gastroenterology, Tsuyama Chuo Hospital, Tsuyama 708-0841, Japan.
World J Gastroenterol. 2016 Jun 21;22(23):5430-5. doi: 10.3748/wjg.v22.i23.5430.
To compare the clinical efficacy of the second-generation H2RA lafutidine with that of lansoprazole in Japanese patients with mild gastroesophageal reflux disease (GERD).
Patients with symptoms of GERD and a diagnosis of grade A reflux esophagitis (according to the Los Angeles classification) were randomized to receive lafutidine (10 mg, twice daily) or lansoprazole (30 mg, once daily) for an initial 8 wk, followed by maintenance treatment comprising half-doses of the assigned drug for 24 wk. The primary endpoint was the frequency and severity of heartburn during initial and maintenance treatment. The secondary endpoints were the sum score of questions 2 and 3 in the Gastrointestinal Symptom Rating Scale (GSRS), and the satisfaction score.
Between April 2012 and March 2013, a total of 53 patients were enrolled, of whom 24 and 29 received lafutidine and lansoprazole, respectively. After 8 wk, the frequency and severity of heartburn was significantly reduced in both groups. However, lafutidine was significantly inferior to lansoprazole with regard to the severity of heartburn during initial and maintenance treatment (P = 0.016). The sum score of questions 2 and 3 in the GSRS, and satisfaction scores were also significantly worse in the lafutidine group than the lansoprazole group (P = 0.0068 and P = 0.0048, respectively).
The clinical efficacy of lafutidine was inferior to that of lansoprazole, even in Japanese patients with mild GERD.
比较第二代H2受体拮抗剂拉呋替丁与兰索拉唑对日本轻度胃食管反流病(GERD)患者的临床疗效。
有GERD症状且诊断为A级反流性食管炎(根据洛杉矶分类法)的患者被随机分为两组,一组接受拉呋替丁(10毫克,每日两次),另一组接受兰索拉唑(30毫克,每日一次),初始治疗8周,随后采用指定药物半量进行维持治疗24周。主要终点是初始治疗和维持治疗期间烧心的频率和严重程度。次要终点是胃肠道症状评定量表(GSRS)中问题2和问题3的总分以及满意度评分。
在2012年4月至2013年3月期间,共纳入53例患者,其中24例接受拉呋替丁治疗,29例接受兰索拉唑治疗。8周后,两组烧心的频率和严重程度均显著降低。然而,在初始治疗和维持治疗期间,拉呋替丁在烧心严重程度方面显著劣于兰索拉唑(P = 0.016)。拉呋替丁组GSRS中问题2和问题3的总分以及满意度评分也显著低于兰索拉唑组(分别为P = 0.0068和P = 0.0048)。
即使对于日本轻度GERD患者,拉呋替丁的临床疗效也低于兰索拉唑。