TOES Evaluations of Abstracts Submitted for the 69th Annual Scientific Meeting of the American College of Gastroenterology
American Journal of Gastroenterology, Vol. 99, No. 10, Suppl., 2004, ©2004 by Am. Coll. of Gastroenterology, ISSN 0002-9270/04/xx.xx, Published by Blackwell Publishing
October 29–November 3, 2004, Orlando, Florida
INTRAGASTRIC pH CONTROL ON TWICE DAILY PROTON PUMP INHIBITORS (PPIS). IS A PPI A PPI?
Jenifer K. Lehrer, Am J Gastro 2004:99 Suppl; A115.
Evidence-based info : Concurrent cohort.
Type of Study : Independent study
Sample size : n = 333 pH studies
Background : PPIs are often given BID. Which of the PPIs is best at achieving pH > 4/24hr period when given BID ?
Primary finding : Esomeprazole (Nexium®) 40mg bid [18.3 hrs control] was similar to Rabeprazole (Aciphex®) 20mg bid [19 hrs] which was similar to Omeprazole (Prilosec®) 20mg bid [17.5 hrs]. Lansoprazole (Prevacid®) 30mg bid [15.4 hrs] and Pantoprazole 40mg bid [15.4 hrs] were not quite as good
Score of Study (TOES): = 20 out of 100
Is it consistent with what we already know? – Yes
How should this affect your practice?
- This is hardly a high enough quality study to “take these numbers to the bank”. This illustrates the importance of bid dosing and that it produces effects that are at the upper end of the dose vs response curve.
- There were really not enough patients in the rabeprazole or pantoprazole arms to make much sense of their data.
- In the final analysis omeprazole 20 mg bid was quite similar to esomeprazole 40 mg bid. Lansoprazole 30 mg bid was not quite as good.