Wachsender Kostendruck im Gesundheitswesen kann zu einer Beeinträchtigung der Behandlungsqualität bei Refluxpatienten führen

Zusammenfassung

Ziel: Direktvergleich der Behandlungsqualität bei Patienten mit gastroösophagealer Refluxkrankheit (GERD) von 40 mg Pantoprazol und 20 mg Omeprazol. Material und Methodik: 915 Patienten mit GERD B-D (Los-Angeles-Klassifikation) wurden in einer doppelblinden randomisierten multizentrischen Studie sechs Wochen mit Pantoprazol 40 mg einmal täglich oder Omeprazol 20 mg einmal täglich behandelt. Primäres Zielkriterium war die Zeit bis zur ersten Symptombefreiung, gemessen mit dem Tagebuch ReQuest^TM-GI. Ergebnisse: Unter Pantoprazol 40 mg war die Zeit bis zur ersten Symptombefreiung signifikant kürzer als unter Omeprazol 20 mg (p = 0,0298). Dabei wurde die Symptombefreiung in den Leitsymptomen von GERD (ermittelt mit dem ReQuest^TM-Tagebuch) unter Pantoprazol 40 mg 2 Tage früher erreicht als unter 20 mg Omeprazol. Auch eine dauerhafte Symptombefreiung wurde mit Pantoprazol früher erzielt. Dabei war die tägliche Symptomlast unter Pantoprazol geringer als unter Omeprazol. Am Studienende nach 6 Wochen waren in beiden Gruppen über 90 % der Patienten symptomfrei (93,7 % unter Pantoprazol vs. 91,8 % unter Omeprazol, PP). Beide Medikamente waren gut verträglich. Schlussfolgerung: Pantoprazol 40 mg befreit GERD-Patienten signifikant schneller von ihren Leitsymptomen als Omeprazol 20 mg. Ein Austausch von Pantoprazol 40 mg durch Omeprazol 20 mg ist daher nicht ohne Verlust an Behandlungsqualität möglich.

Abstract

Aims: To directly compare the efficacy and safety of pantoprazole 40 mg vs. omeprazole 20 mg in patients with gastroesophageal reflux disease (GERD). Material and Methods: 915 Patients suffering from symptomatic GERD B-D (Los Angeles classification) were included in a double-blind randomized multicenter clinical trial and treated with either pantoprazole 40 mg od or omeprazole 20 mg od for six weeks. Primary efficacy criterion was the first time to reach normal symptoms as assessed by the questionnaire ReQuest^TM-GI. Results: Compared to omeprazole 20 mg, pantoprazole 40 mg achieved a significantly faster rate of symptom relief (p = 0.0298). Thus, as assessed with the ReQuest^TM questionnaire, patients treated with pantoprazole 40 mg experienced relief from the 7 leading GERD symptoms 2 days earlier than those treated with omeprazole 20 mg. Long-lasting sustained relief from symptoms was also achieved earlier with pantoprazole than with omeprazole; in patients treated with pantoprazole, the daily symptom load was lower than in those treated with omeprazole. After 6 weeks of treatment, over 90 percent of patients were free from symptoms in both treatment groups (93.7 % in the pantoprazole, vs. 91.8 % in the omeprazole group, PP). Both medications were well tolerated. Conclusions: GERD patients treated with pantoprazole 40 mg experience a significantly faster relief from their leading symptoms than those treated with omeprazole 20 mg.

GERD - Refluxösophagitis - Reflux - Refluxkrankheit - Symptom - Symptomscore - Pantoprazol - Omeprazol - ReQuest^TM

GERD - refluxesophagitis - reflux - esophagitis - symptoms - symptomscore - pantoprazole - omeprazole - ReQuest^TM

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