ORAL ESOMEPRAZOLE VS. INTRAVENOUS PANTOPRAZOLE - EFFECT ON INTRAGASTRIC pH IN HEALTHY VOLUNTEERS

D Armstrong¹, D Bair¹, L Tanser², C James¹, S Escobedo², K Nevin²

¹Division of Gastroenterology, McMaster University/Hamilton Health Sciences, Ontario; ²AstraZeneca Canada Inc, Mississauga, Ontario

AIMS: Pantoprazole IV (P-IV) is used widely for hospital in-patients requiring effective acid suppression; however, the costs of therapy might be reduced if an equivalent oral regimen were available. Previous work indicates that oral esomeprazole (E-O) produces greater acid suppression than oral pantoprazole; this study was performed to determine if E-O produces greater gastric acid suppression than P-IV in comparable doses.
METHODS: 29 healthy H. pylori negative volunteers (20M,9F) participated in a single-centre, open-label 2-way cross-over study. All subjects underwent baseline gastric pH-metry before randomization to 40mg od of either E-O or P-IV for 5 consecutive days; 24-hour gastric pH-metry was performed on days 1 and 5 of each treatment period with a 2-week wash-out between treatment periods.
RESULTS: E-O led to a greater percentage of time than P-IV with pH>3, >4 and >5 on days 1 and 5 (p< 0.001, Table) and with pH>6 on day 5 (p<0.045). Adverse events were minor and similar between the two groups.
CONCLUSION: In healthy volunteers, oral esomeprazole produced greater acid suppression on days 1 and 5 than did IV pantoprazole. Oral esomeprazole showed a significant difference in pH> 6 on day 5. Oral esomeprazole may be appropriate therapy for patients who require effective acid suppression therapy and can tolerate oral medication.

Sponsored by AstraZeneca Canada Inc., Mississauga, Ontario