Dergiler / Turkish Journal of Gastroenterology / 2001 / Cilt: 12 - Sayı: 2
Comparison of lansoprazole and omeprazole treatment in grade II and III reflux esophagitis
- Sayfa
- 117–121
- DOI
- —
Özet
Amaç: Proton pompası inhibitörlerinin(PPİ) özofagusta striktür ve ülserasyonları da kapsayan ileri özofajitlerin tedavisindeki etkinlikleri birçok çalışmada gösterilmiştir. Bu çalışmada PPİ'lerinden omeprazol ve Lansoprazol'ün Savary-Miller Evre II ve III özofajit tedavisindeki etkinlikleri kıyaslanmaktadır. Yöntem: Evre II ve III reflü özofajiti bulunan ve 24-saatlik ambulatuar pH-metre analizi yapılabilmiş 62 hasta çalışmaya alındı. Hastalar randomizasyonla Grup I (n=42) ve Grup II (n=30) olarak ayrılmıştır. Grup I 40 mg/gün omeprazol,Grup II ise 60 mg/gün lansoprazol almıştır. Endoskopi, semptom skorlaması ve 24 saatlik pH metre 12 haftalık tedaviden sonra Grup I'de38, Grup II de ise 29 hastada tekrarlanabildi. Bulgular: Tam iyileşme Grup I de 31 (%84),Grup II'de ise 24(%83) hastada görülmüştür. Heriki grupta üçer hastada (Grup I' de %8.5, Grup II'de %11.5) özofajit evresinde düşme gözlenmiştir.İki grupta da kontrol 24-saatli pH metrede ortalama DeMeester skorları anlamlı olarak düşmüstür. Sonuç: Omeprazol ve lansoprazol ileri reflü özofajit tedavisinde aynı ölçüde etkin bulunmuştur. İlaç seçimi kurumların tercihidir.
Abstract
Background/Aims: Proton pump inhibitors have been shown by several studies to be effective in the healing of severe esophagitis, including esophageal stricture and ulcers and in maintaining these patients in remission. In this study, the effectiveness of two proton pump inhibitors (omeprazole and lansoprazole) was compared in the treatment of Savary-Miller grade II and III patients. Methods: Seventy two patients with Grade II or III esophagitis, who underwent upper endoscopy and were assessed for reflux symptoms by 24 hour ambulatory pH meter, were included in the study. They were randomly allocated to Group I (n=42) which received omeprazole 40 mg/day or Group II (n=30) which received lansoprazole 60 mg/day. Endoscopy, symptom scoring and 24hour-ambulatory pH meter were repeated on 38 patients in group I and 29 patients in Group II after 12 weeks of treatment. Results: Complete healing on endoscopy was observed in 84% of Group I and 83% of Group II patients. Downgrading of esophagitis was observed in three patients in each group (8. 5% and 11. 5% respectively). Non-healing was found in four and two patients in Group I and II respectively. Mean DeMeester reflux score on 24-hour ambulatory pH-meter reduced significantly in both groups (44. 217 vs. 20. 710 and 44. 334 vs 21. 724 respectively). Conclusions: Omeprazole and lansoprazole provide an acceptable healing rate in severe reflux esophagitis. No significant difference was observed between these agents regarding their potency and commencment of symptom relief. Choice of therapy seems likely to be due to institutional preference