Martin J, MacAulay S; International Society of Technology Assessment in Health Care. Meeting (19th : 2003 : Canmore, Alta.).

Annu Meet Int Soc Technol Assess Health Care Int Soc Technol Assess Health Care Meet. 2003; 19: abstract no. 251.

Evidence-Based Prescribing Initiative, London Health Sciences Centre, Room S121, 375 South Street, London, ON N6A 4G5 Canada Tel: 519-685-8500 x77814, Fax: 519-667-6811, E-mail: janet.martin@lhsc.on.ca

BACKGROUND: It is suggested that esomeprazole, the S-isomer of omeprazole, has superior pharmacologic and clinical effects compared with its racemic parent compound. PURPOSE: To determine whether esomeprazole (ESO) is superior to omeprazole (OME) for reducing symptoms and signs of gastro-esophageal reflux disease (GERD).METHODS: Randomized trials comparing ESO with OME in GERD were sought through searches of MEDLINE, Cochrane Library and abstract databases. Two reviewers independently extracted data. Primary and secondary outcomes were symptom resolution and endoscopic healing, respectively. Adverse effects were evaluated. Odds ratios (95%CI) were calculated. RESULTS: Two randomized trials, including 4296 patients with confirmed GERD were identified. One trial compared ESO 40mg with OME 20mg daily, and one trial compared ESO 40mg, ESO 20mg, and OME 20mg daily. ESO 40mg daily significantly improved heartburn resolution compared with OME 20mg daily (OR 1.31, 95%CI 1.13 to 1.51), but no difference was found when ESO 20mg and OME 20mg daily were compared (OR, 1.17, 95%CI 0.93 to 1.49). While ESO 40mg daily significantly improved endoscopically-proven healing at 8 weeks compared with OME 20mg daily (OR 2.65, 95%CI 2.10 to 3.33), there was no difference between ESO 20mg versus OME 20mg daily (OR 1.33, 95%CI 0.94 to 1.88). Similar adverse event rates were reported for ESO and OME. CONCLUSION: Claims of superiority of ESO over OME for GERD are not supported by the evidence. Further trials with fair dose comparisons are required to determine whether the purported advantages of ESO translate into clinically important differences.

Publication Types:

• Meeting Abstracts

Keywords:

• Clinical Trials as Topic
• Gastroesophageal Reflux
• Heartburn
• Humans
• Odds Ratio
• Omeprazole
• United States
• hsrmtgs

Other ID:

• GWHSR0004484

UI: 102276169

From Meeting Abstracts