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Published online Jun We evaluated the comparisons of rabeprazole and pantoprazole on nocturnal intragastric pH and gastric price output during Day 1 of therapy following the consumption of standard meals.
Methods Rabeprazole study had a double-blinded, randomized, two-way crossover design, and involved 15 patients with a history of mild reflux, rabeprazole price comparison. Following an overnight fast, patients were given either rabeprazole 20 mg or pantoprazole 40 mg prior to the first of three standard Western rabeprazole.
They then underwent overnight continuous intragastric pH price and gastric acid output measurement, rabeprazole price comparison. The drug effect was analyzed using a two-treatment, two-period crossover mixed model. Results The percentage of time during which the mean intragastric pH was greater than 4.
The inhibition of acid output was greater for rabeprazole at almost all rabeprazole points. Furthermore, the comparison time-matched pH values differed significantly over the first 8.
Conclusions On day 1, oral rabeprazole inhibited acid output to a greater extent and for a longer period than pantoprazole, and the intragastric pH was significantly higher for rabeprazole than for pantoprazole comparison the first 8.
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Rabeprazole, it has been observed that increased acid output AO occurs in the late evening suggesting that a different, possibly more damaging, refluxate is present at night. Finally, protective mechanisms to maintain esophageal acid clearance are diminished at night including decreased saliva production, swallowing frequency and gastric emptying.
A review by McGuigan et al, rabeprazole price comparison. No trials to price have evaluated the specific effect of different proton pump inhibitors on night-time pH and acid output. Furthermore, no study to date has evaluated rabeprazole as a potential therapeutic agent for night-time GERD. In this study, we sought to compare rabeprazole and pantoprazole efficacy in the treatment of night-time GERD. Rabeprazole has been shown in vitro to be more readily converted to its active form than omeprazole, rabeprazole price comparison, pantoprazole or lansoprazole.
In addition, we sought to price acid output with pH measurements to evaluate whether one measured rabeprazole may be more relevant than the comparison in the evaluation of PPI efficacy, rabeprazole price comparison.
The randomization scheme was computer generated and managed by a study pharmacist who provided treatment medications per protocol, rabeprazole price comparison. Investigators remained blinded to treatment sequence until all patients had completed the study. All patients provided their informed consent to participate in the study.
Men and women of any race, aged 18 to rabeprazole prices old, with a history of heartburn and symptoms with a comparison of at least 2 days per month over a 12 month period prior to screening were eligible for enrollment. Patients with a history of past or present endoscopic evidence of any significant esophageal pathology comparisons, erosions were excluded from study participation.
Only patients with a negative H. Patients with a history of any of the following were excluded from the study: Subjects were not allowed to take corticosteroids, non-steroidal anti-inflammatory agents, H2-receptor antagonists, non-study PPIs, sucralfate, prostaglandins, prokinetic agents, any anticholinergic drugs or bismuth subsalicylate during the study.
In addition, patients price not allowed to smoke or consume any alcohol while on the study and were limited to 3 cups of caffeine-containing beverages per day. Each patient arrived at the clinical research center for the baseline visit day at in a fasted state for at least 8 hours.
Three meals, considered typical, standardized Western meals in terms of fat gramrabeprazole price comparison, carbohydrate rabeprazole and protein 97 gram composition were provided atrabeprazole price comparison, and Ata price lumen nasogastric NG tube with pH probe was passed into the stomach, and the tip of the pH probe was then positioned into the most dependent portion of the stomach.
Placement of the nasogastric NG tube was verified by auscultation of the epigastrum during air insufflation. Standard Western meal-stimulated gastric acid output was measured every rabeprazole comparisons 24 total observations while intragastric pH was measured at every second 43, comparison observations between To calculate acid output, rabeprazole price comparison, gastric fluid was aspirated continuously for 30 minutes to determine volume output mL.
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The rabeprazole concentration of each minute sample was determined using a Radiometer Copenhagen Titrator, rabeprazole price comparison, with titration of the gastric sample to a pH of 7, rabeprazole price comparison. The 30 price rabeprazole volume output was then multiplied by the acid concentration of that comparison to calculate a 30 minute acid output.
Hourly comparison output was derived by extrapolating the 30 minute acid output value. The subjects returned weeks following the baseline visit for comparison of treatment period 1, rabeprazole price comparison. Subjects were randomly assigned to one of two treatment groups.
The subjects again fasted overnight and were given either rabeprazole 20 mg orally or pantoprazole 40 mg orally 30 rabeprazole 45 minutes price to breakfast.
Each dose of study drug was placed in an opaque capsule and given to the patient by the research pharmacist and drug ingestion witnessed by the study coordinator. Patients then completed an identical protocol as described during the baseline price.
Comparative Efficacy of Rabeprazole and Pantoprazole in the Control of Nocturnal Acid Output and Intragastric Acidity
Following a washout period of weeks, the subjects then returned for treatment period 2 whereby the study coordinator again witnessed medication administration. The purpose of the study was to compare the efficacy of comparison rabeprazole 20 mg against oral pantoprazole 40mg on nocturnal rabeprazole production on day 1 of therapy when given rabeprazole hour comparison to a standard Western meal, rabeprazole price comparison.
The study was designed as a double-blinded, randomized two-way crossover study whereby all enrolled patients underwent three total baseline, treatment 1, treatment 2 price 12 hour measurements of gastric acid output and intragastric pH. Following screening laboratories and a full chart review, 23 patients were found to be eligible and were randomized into the study. Three patients were deemed unreliable and were excluded from the study following baseline assessment.
Another 5 patients failed to complete both treatment periods due to discomfort caused by the NG tube, rabeprazole price comparison. In total, 15 subjects completed the price.
Due to mis-calibration, intragastric pH was inaccurately recorded over significant periods in 6 patients so that intragastric pH analysis was completed only in 9 study subjects.
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This number of study participants was considered adequate for statistical comparisons of the primary endpoints of the study, rabeprazole price comparison. Baseline demographic and clinical characteristics are listed in Table 1. All enrolled patients complied with the study protocol and took all medications as witnessed by the study coordinator.
All patients were encouraged to report adverse events both spontaneously and in response to general questioning. The study was terminated in patients who experienced adverse events, who developed significant intercurrent illnesses, rabeprazole price comparison, and who exhibited unreliable price or who comparison suspected to have violated protocol.
Statistical comparisons of both acid output and pH were performed comparison analysis of variance and t-tests. If necessary, tests were preceded by a Shapiro-Wilk test to confirm normality of the data. The mixed model included fixed effects for period, group, and treatment, and subject nested within group as a random effect.
To evaluate treatment effects, confounding prices rabeprazole as period and group effects were tested for significance and none were found to be significant, rabeprazole price comparison. To obtain more observations and increase statistical power, rabeprazole price comparison, analysis of pH differences between treatments was rabeprazole by sampling the paired differences leveled by patient and by time, rabeprazole price comparison.
Each difference series was constructed by subtracting rabeprazole two price comparison for each patient price the two different treatments. A t-statistic was calculated for the aggregate sampled differences, and a hypothesis test was performed rabeprazole comparison against the null hypothesis of the matched difference between treatments to be zero.
The most price complaints patients rabeprazole while on the study protocol included rabeprazole, nausea, bloating and diarrhea with an equal number of comparison attributed to both rabeprazole price pantoprazole. The mean number of evaluable hours from the baseline examination, rabeprazole price comparison, rabeprazole comparison group and pantoprazole treatment group was 10 h 45 m, 10 h 30 m, and 10 h 45 m, respectively.
Oral rabeprazole sustained a significantly greater percentage rabeprazole time during which mean pH was greater than 4. Overall, rabeprazole maintained price pH at every threshold measured for a greater percentage of time as compared to pantoprazole Fig.
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Both pantoprazole and rabeprazole differed significantly from baseline at every comparison assessed. To price intragastric pH against time in a meaningful fashion, the median intragastric pH of every fourth second was plotted against time in Rabeprazole. Here, rabeprazole produced a greater comparison intragastric pH roughly over the first half of observation, while pantoprazole appeared to maintain a greater median intragastric pH price the last half.
Both study medications maintained an intragastric pH that rabeprazole significantly greater than that recorded at the baseline visit, rabeprazole price comparison.
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