Decreasing oesophageal acid exposure in patients with GERD: a comparison of rabeprazole and omeprazole

Background: Rabeprazole has been shown to be more potent and faster than ot her proton pump inhibitors in in vitro studies and highly effective in decr easing oesophageal acid exposure in patients with gastrooesophageal reflux disease (GERD). Aim: This study was a multicentre, double-blind, placebo-controlled, random ized, parallel-group comparison of three active treatment regimens utilizin g two different proton pump inhibitors, or placebo, administered over 7 day s in patients with GERD. Methods: Eighty-two patients with symptomatic GERD were given placebo, rabe prazole 10 mg b.d., rabeprazole 20 mg o.m., or omeprazole 20 mg o.m. for 7 days. Twenty-four hour oesophageal pH monitoring was performed at baseline and repeated at the conclusion of the treatment period. Results: At the end of study, the percentage time (mean +/- s.d.) with pH < 4 over a 24-h period was significantly decreased by the three active regim ens but without significant difference between them (9.27 <plus/minus> 4.77 ; 2.53 +/- 4.27; 2.02 +/- 1.71 and 2.91 +/- 4.06 for placebo, rabeprazole 1 0 mg b.d., rabeprazole 20 mg o.m. and omeprazole 20 mg o.m., respectively). Acid exposure was normalized in 90% of patients treated with rabeprazole 1 0 mg b.d., 95% treated with rabeprazole 20 mg o.m., 78% treated with omepra zole 20 mg o.m., and only 9.5% of patients treated with placebo. Both rabep razole and omeprazole were well-tolerated. Conclusions: Although rabeprazole 20 mg o.m. showed greater activity numeri cally, this study demonstrates that rabeprazole 10 mg b.d. and 20 mg o.m. a re equivalent to omeprazole 20 mg o.m. in decreasing oesophageal acid expos ure.