Skip to main content
Log in

Treatment of erosive reflux esophagitis resistant to H2-receptor antagonist therapy

Lansoprazole, a new proton pump inhibitor

  • Esophageal, Gastric, And Duodenal Disorders
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Fifty-four patients with endoscopically documented therapy-resistant erosive reflux esophagitis were treated with lansoprazole, a new proton pump inhibitor, for up to 12 weeks. Prior to entry, all had remained unhealed after treatment with at least two histamine2-receptor antagonists, at therapeutic doses or higher, for at least 12 weeks. Patients were randomized to receive either 30 or 60 mg lansoprazole once daily. Endoscopy was performed and symptoms assessed at weeks 2, 4, 6, 8, and 12. Fifty-nine percent of the 50 evaluable patients were healed (ie, no evidence of erosions) after only two weeks of lansoprazole. Cumulative endoscopic healing rates were 82% and 92% by week 4 and week 8, respectively, and the two doses were equally effective in healing. The 30- and 60-mg doses effected a decrease in the overall symptom score from 5.30 and 4.85 to 2.35 and 1.67, respectively, by the final treatment visit (P=0.001). No clinically significant adverse events or changes in laboratory parameters were observed, and no patients withdrew prematurely from the study. This study demonstrates that lansoprazole therapy is highly effective in healing erosive reflux esophagitis resistant to therapy with histamine H2-receptor antagonists.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Sontag SJ: The medical management of reflux esophagitis. Role of antacids and acid inhibition. Gastroenterol Clin of North Am 19(3):683–712, 1990

    Google Scholar 

  2. Hetzel DJ, Dent J, Reed WD, Narielvala FM, Mackinnon M, McCarthy HJ, Mitchell B, Beveridge BR, Laurence BH, Gibson GG, Grant AK, Shearman DJC, Whitehead R, Buckle PJ: Healing and relapse of severe peptic oesophagitis after treatment with omeprazole. Gastroenterology 95:903–912, 1988

    PubMed  Google Scholar 

  3. Sontag SJ, Hirschowitz BI, Holt S, Robinson MG, Behar J, Berenson MM, McCullough A, Ippoliti AF, Richter JE, Ahtaridis G, McCallum RW, Pambianco DH, Vlahcevic RZ, Johnson DA, Collen MJ, Lyon DT, Humphries TH, Cagliola A, Berman RS: Two doses of omeprazole versus placebo in symptomatic erosive esophagitis. The U.S. Multicenter Study. Gastroenterology 102:109–118, 1992

    PubMed  Google Scholar 

  4. Sugiyama M, Ishikawa T, Aoki T, Kashiwagi H, Watanabe Y, Sasaki H, Yoshino K: Effect of lansoprazole (AG-1749) on gastric acidd secretion—inhibition of insulin-stimulated acid secretion. Shokakika 14(2):183–193, 1991

    Google Scholar 

  5. Hogan DL, Koss MA, Feitelberg S, Hussein Z, Karol MD, Isenberg JI: Single and repetitive administration of lansoprazole: Effects on gastric acid secretion, pharmacokinetics and serum gastrin in old vs young subjects. Gastroenterology 100:A84, 1991 (abstract)

    Google Scholar 

  6. Matsuo Y, Takemoto T, Miwa T, Iwasaki A, Asaoka A: Clinical study of the inhibitory effect of AG-1749, a proton pump inhibitor, on nocturnal gastric acid secretion: Evaluation of dosage and administration stage. Yakuri to Chiryo 18:4865–4876, 1990

    Google Scholar 

  7. Barradell LB, Faulds D, McTavish D: Lansoprazole. A review of its pharmacodynamic and pharmacokinetic properties and its therapeutic efficacy in acid-related disorders. Drugs 44(2):225–250, 1992

    PubMed  Google Scholar 

  8. Hatlebakk JG, Berstad A, Carling L, Suedberg L-E, Unge P, Ekstrom P: Lansoprazole vs omeprazole in short-term treatment of reflux esophagitis. Results of a Scandinavian multicentre trial. Gastroenterology 102:A80, 1992 (abstract)

    Google Scholar 

  9. Savary M, Miller G: Der Oesophagus. Solothrun, Gasmann, 1977

  10. Klinkenberg-Knol EC, Jansen JBMJ, Lamers CBWH, Nelis F, Snell P, Meuwissen SG: Use of omeprazole in the management of reflux oesophagitis resistant to H2-receptor antagonists. Scand J Gastroenterol 24(suppl 166):88–93, 1989

    Google Scholar 

  11. Lundell L, Backman L, Ekstrom P, Enander LH, Fausa O, Lind T, Lonroth H, Sandmark S, Sandzen B, Unge P, Westin IH: Omeprazole or high-dose ranitidine in the treatment of patients with reflux oesophagitis not responding to ‘standard doses’ of H2-receptor antagonists. Aliment Pharmacol Ther 4:145–55, 1990

    PubMed  Google Scholar 

  12. Bardhan KD, Long R, Hawkey CJ, Wormsley KG, Brocklebank D, Moules I: Lansoprazole, a new proton-pump inhibitor, vs ranitidine in the treatment of reflux erosive esophagitis. Gastroenterology 100:A30, 1991 (abstract)

    Google Scholar 

  13. Collen MJ, Lewis JH, Benjamin SB: Gastric acid hypersecretion in refractory gastroesophageal reflux disease. Gastroenterology 98:654–661, 1990

    PubMed  Google Scholar 

  14. Bell NJV, Burget DL, Howden CW, Wilkinson J, Hunt RH: Appropriate acid suppression for the management of gastro-oesophageal reflux disease. Digestion 51(suppl 1):59–67, 1992

    PubMed  Google Scholar 

  15. Muller P, Drammann HG, Leucht U, Simon B: Human gastric acid secretion following repeated doses of AG-1749. Aliment Pharmacol Ther 3:193–198, 1989

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

Supported by a grant from TAP Pharmaceuticals Inc., Deerfield, Illinois.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Robinson, M., Campbell, D.R., Sontag, S. et al. Treatment of erosive reflux esophagitis resistant to H2-receptor antagonist therapy. Digest Dis Sci 40, 590–597 (1995). https://doi.org/10.1007/BF02064376

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02064376

Key Words

Navigation