Lansoprazole in the treatment of gastro-oesophageal reflux disease in childhood

• Published in: Digestive and liver disease 2000-11, Vol.32 (8), p.660-666
• Main Authors: Franco, M T, Salvia, G, Terrin, G, Spadaro, R, De Rosa, I, Iula, V D, Cucchiara, S
• Format: Article
• Language: English
• Subjects: 2-Pyridinylmethylsulfinylbenzimidazoles; Adolescent; Child; Child, Preschool; Enzyme Inhibitors - administration & dosage; Enzyme Inhibitors - therapeutic use; Esophagitis - drug therapy; Esophagitis - etiology; Female; Gastric Acid - metabolism; Gastroesophageal Reflux - diagnosis; Gastroesophageal Reflux - drug therapy; Gastroesophageal Reflux - metabolism; Gastrointestinal Agents - administration & dosage; Gastrointestinal Agents - therapeutic use; Humans; Hydrogen-Ion Concentration; Lansoprazole; Male; Omeprazole - administration & dosage; Omeprazole - analogs & derivatives; Omeprazole - therapeutic use; Proton Pump Inhibitors
• ISSN: 1590-8658
• DOI: 10.1016/S1590-8658(00)80326-6

Acid suppressive therapy is the mainstay of pharmacologic treatment of gastro-oesophageal reflux disease. Use of proton pump inhibitors in children is still limited and has only included omeprazole in a few controlled studies. To determine efficacy of lansoprazole, a relatively new proton pump inhibitor, on symptoms and oesophagitis in a group of children with gastro-oesophageal reflux disease refractory to H2 receptor antagonists. The required dose of the drug for inhibiting gastric acidity was also determined. A series of 35 children (median age: 7.6 years, range: 3-15) with oesophagitis refractory to H2 receptor antagonists received a 12-week therapeutic course with lansoprazole. Prior to the study children underwent symptomatic and endoscopic assessment, oesophageal manometry and 24-hour intragastric and intra-oesophageal pH test. The latter was repeated after one week of therapy while patients were on treatment in order to monitor the degree of acid suppression and adjust the dose of the drug. Symptomatic assessment and endoscopy were repeated at the end of the trial In 12 patients (group A), the initial dose of the drug was efficacious (1.3 to 1.5 mg/kg/day), whereas in 23 [group B) the initial dose (0.8 to 1.0 mg/kg/day) was increased by half because of insufficient inhibition of intragastric acidity (i.e., when the intra-gastric pH remained below 4.0 for more than 50% of the recording time). Nine patients in group A (75%) and 8 in group B (53.5%) healed (chi2: 3.6, p