Esomeprazole

Esomeprazole, a new proton pump inhibitor, is the S-isomer of omeprazole an d is the first such inhibitor to be developed as a single isomer. Esomeprazole provided better control of intragastric pH than omeprazole, la nsoprazole and pantoprazole in trials conducted in patients with gastro-oes ophagral reflux disease (GORD) or healthy volunteers (n = 20 to 115), In 2 large randomised, double-blind multicentre trials esomeprazole 20 and/ or 40mg for 8 weeks produced higher healing rates of erosive oesophagitis a nd better symptom control than omeprazole 20mg in patients with GORD. Esomeprazole 10, 20 or40mg once daily for 6 months maintained healing versu s placebo (p < 0.001) in patients with endoscopically confirmed healed eros ive oesophagitis in 2 large randomised, double-blind multicentre trials, Similarly, symptom-driven on-demand use of esomeprazole effectively control led symptoms of GORD (heartburn) for 6 months in 2 large placebo-controlled trials. Esomeprazole-based triple therapy for 7 days was as effective for eradicati on of Helicobacter pylori as longer omeprazole-based therapy in 2 randomise d double-blind trials including about 450 patients each. Endoscopically con firmed ulcer healing 4 weeks after treatment initiation was reported in abo ut 90% of patients with active duodenal ulcer in both treatment groups. Esomeprazole-based triple therapy for 10 days was more effective than esome prazole plus clarithromycin for eradication of H. pylori in 233 patients.