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
COMPARISON OF GASTRIC ACID PH WITH OMEPRAZOLE
MAGNESIUM 20.6 MG (PRILOSEC OTC®) .d., FAMOTIDINE 10
MG b.i.d (PEPCID AC®) AND FAMOTIDINE 20 MG b.i.d. OVER
14-DAYS OF TREATMENT.
Miner PP, et al. Am J Gastro 2004:99 Suppl; A23.
Evidence-based info: A prospective, randomized, double blind, cross-over trial.
Type of Study: Marketing
Sample size: n = 30
Primary finding: see table
Pepcid AC® 10 mg daily vs. OTC Prilosec® 20 mg daily vs. Famotidine 20mg bid
Baseline |
time pH>4 |
17% (4 hrs) |
16% (4 hrs) |
14% (3.5 hrs) |
Day 1 |
time pH>4 |
34% (8 hrs) |
40% (9.5 hr) |
40% (9.5 hrs) |
Day 3 |
time pH>4 |
25% (6 hrs) |
53% (12.7 hr) |
30% (7 hrs) |
Day 14 |
time pH>4 |
19% (4.5 hrs) |
59% (14 hrs) |
25% (6 hrs) |
Score of Study (TOES): = 85 out of 100
Is it consistent with what we already know? - Yes
How should this effect your practice?
- H-2 blockers work best for a single event (such as prn). Even 10mg famotdine will protect for 8 hrs or so.
- The more you take the H2 blockers the less well they work (tachyphylaxis or tolerance)
- A full dose of PPI (delayed-release) works about as well as 2 doses of full dose-20mg bid famotidine (not the OTC dose). ONLY ON DAY ONE THOUGH.
- PPIs (delayed release) take a few days before they really kick in. In this study it took 7 days to get to 14 hrs of protection per day for OTC omeprazole.