Ninety‐six‐hour wireless oesophageal pH monitoring following proton pump inhibitor administration in NERD patients

• Published in: Alimentary pharmacology & therapeutics 2008-07, Vol.28 (2), p.250-255
• Main Authors: CALABRESE, C., LIGUORI, G., GABUSI, V., GIONCHETTI, P., RIZZELLO, F., STRAFORINI, G., BRUGNERA, R., DI FEBO, G.
• Format: Article
• Language: English
• Subjects: 2-Pyridinylmethylsulfinylbenzimidazoles - administration & dosage; 2-Pyridinylmethylsulfinylbenzimidazoles - therapeutic use; Adult; Anti-Ulcer Agents - administration & dosage; Anti-Ulcer Agents - therapeutic use; Biological and medical sciences; Digestive system; Esophageal pH Monitoring; Female; Gastroenterology. Liver. Pancreas. Abdomen; Gastroesophageal Reflux - drug therapy; Humans; Lansoprazole; Male; Medical sciences; Middle Aged; Omeprazole - administration & dosage; Omeprazole - therapeutic use; Pharmacology. Drug treatments; Proton Pump Inhibitors - therapeutic use; Treatment Outcome
• ISSN: 0269-2813; 1365-2036
• DOI: 10.1111/j.1365-2036.2008.03733.x

Summary Background  Comparative studies of proton pump inhibitors (PPIs) have revealed that acid reflux is influenced by PPI treatment, formulations and dosing regimens. Wireless pH capsules have circumvented some of the limitations of conventional catheter‐based pH testing with the additional advantage of 96‐h recording periods. Aim  To clarify the effectiveness of intra‐oesophageal acid suppression by omeprazole, pantoprazole and lansoprazole in non‐erosive reflux disease patients through a 4‐day monitoring of oesophageal pH and related symptoms. Methods  Twenty‐four patients with typical symptoms of gastro‐oesophageal reflux disease were enrolled and administered upper endoscopy and placement of a wireless pH capsule. Patients randomly received omeprazole, pantoprazole or lansoprazole for 3 days after the first 24 h. Symptom–reflux associations were expressed using the symptom index (SI). Results  All patients completed the study. Significant decrease in acid exposure occurred on day 2 and in each successive day in all groups. Pantoprazole and omeprazole are more effective than lansoprazole at inducing a normalization of intra‐oesophageal acid exposure at days 2 and 3. Significant reduction in SI at day 2 was observed. Conclusions  Four‐day ambulatory oesophageal pH monitoring is feasible and safe. Omeprazole, pantoprazole and lansoprazole have an equivalent potency for normalizing intra‐oesophageal acid exposure after 3 days of treatment in non‐erosive reflux disease patients.