Comparative study of omeprazole, lansoprazole, pantoprazole and esomeprazole for symptom relief in patients with reflux esophagitis

AIM: To clarify whether there is any difference in the symptom relief in patients with reflux esophagitis following the administration of four Proton pump inhibitors (PPIs).METHODS: Two hundred and seventy-four patients with erosive reflux esophagitis were randomized to receive 8 wk of 20 mg omeprazole ( n = 68), 30 mg of lansoprazole ( n = 69), 40 mg of pantoprazole ( n= 69), 40 mg of esomeprazole ( n = 68) once a day in the morning. Daily changes in heartburn and acid reflux symptoms in the first 7 d of administration were assessed using a six-point scale (0: none; 1: mild; 2:mild-moderate; 3: moderate; 4: moderate-severe; 5:severe).RESULTS: The mean heartburn score in patients treated with esomeprazole more rapidly decreased than those receiving other PPI. Complete resolution of heartburn was also more rapid in patients treated with esomeprazole for 5 d compared with omeprazole ( P = 0.0018, P = 0.0098, P = 0.0027, P = 0.0137, P = 0.0069,respectively), lansoprazole ( P = 0.0020, P = 0.0046, P= 0.0037, P = 0.0016, P = 0.0076, respectively), and pantoprazole ( P = 0.0006, P = 0.0005, P = 0.0009, P =0.0031, P = 0.0119, respectively). There were no significant differences between the four groups in the rate of endoscopic healing of reflux esophagitis at week 8.CONCLUSION: Esomeprazole may be more effective than omeprazole, lansoprazole, and pantoprazole for the rapid relief of heartburn symptoms and acid reflux symptoms in patients with reflux esophagitis.