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No randomized controlled trial has compared all European-licensed standard- and double-dose proton pump inhibitors (PPIs) for the healing of severe erosive esophagitis.
Dr Edwards and colleagues from the United Kingdom compared the effectiveness of licensed doses of PPIs for healing severe erosive esophagitis (i.e. esomeprazole 40 mg, lansoprazole 30 mg, omeprazole 20 mg and 40 mg, pantoprazole 40 mg and rabeprazole 20 mg).
The team performed systematic review of CENTRAL, EMBASE and MEDLINE for controlled trials in patients with erosive esophagitis.
Endoscopically verified healing rates at 4 and 8 weeks were extracted and re-calculated if not analyzed by intention-to-treat.
A mixed treatment comparison was used to combine direct treatment comparisons with indirect trial evidence while maintaining randomization.
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| 12 studies were included included in the analysis |
| Alimentary Pharmacology & Therapeutics |
Odds ratios are reported compared to omeprazole 20 mg.
The researchers identified a total of 3021 papers in the literature search, of which 12 were of sufficient quality to be included in the analysis.
Insufficient data were available to included rabeprazole.
The team found that esomeprazole 40 mg to provide significantly higher healing rates at 4 weeks, and 8 weeks.
No other PPI investigated had significantly higher healing rates than omeprazole 20 mg.
Dr Edwards' team concluded, “Esomeprazole 40 mg consistently demonstrates higher healing rates compared with licensed standard- and double-dose PPIs.”
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