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Nunes GP, Silveira TC, Marciano JVS, dos Reis-Prado AH, Ferrisse TM, dos Anjos EB, Fernandes MH. The Effect of Dexlansoprazole on Gastroesophageal Reflux Disease: A Systematic Review and Meta-Analysis. Int J Mol Sci 2024; 25:1247. [PMID: 38279248 PMCID: PMC10816097 DOI: 10.3390/ijms25021247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/16/2024] [Accepted: 01/17/2024] [Indexed: 01/28/2024] Open
Abstract
This systematic review and meta-analysis evaluated the efficacy of dexlansoprazole (a proton pump inhibitor-PPI) in resolving heartburn, reflux, and other symptoms and complications resulting from gastroesophageal reflux disease (GERD). The study followed PRISMA 2020 and was registered in PROSPERO (CRD42020206513). The search strategy used MeSH and free terms appropriately adapted for each database. Only randomized clinical trials (RCTs) were included. The Cochrane tool (RoB 2.0) was used to assess the risk of bias, and the certainty of evidence was rated using GRADE. Ten RCTs were included. Dexlansoprazole outperformed the placebo and other PPIs in the resolution of heartburn and reflux symptoms in patients with GERD, with benefits during and after treatment, especially in those with moderate and severe symptoms. The meta-analyses indicated that dexlansoprazole at doses of 30 and 60 mg had more 24 h heartburn-free days and nights compared to the placebo medications; no difference was reported between dexlansoprazole at doses of 30 and 60 mg in heartburn-free nights. A low bias risk and a moderate certainty of evidence were observed. This review confirms the therapeutic effect of dexlansoprazole (placebo-controlled) and its improvements in GERD symptoms compared to another PPI. However, the interpretation of the results should be carried out cautiously due to the small number of included studies and other reported limitations.
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Affiliation(s)
- Gabriel Pereira Nunes
- Department of Restorative and Preventive Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16018-805, Brazil;
- Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, University of Porto, 4160-007 Porto, Portugal
- Associated Laboratory for Green Chemistry—LAQV/REQUIMTE, University of Porto, 4050-453 Porto, Portugal
| | - Thayná Cerqueira Silveira
- Department of Medicine, Institute of Health Sciences (ICS), United Colleges of Northern Minas (FUNORTE), Montes Claros 39404-006, Brazil
| | - João Vítor Silveira Marciano
- Department of Medicine, Institute of Health Sciences (ICS), United Colleges of Northern Minas (FUNORTE), Montes Claros 39404-006, Brazil
| | - Alexandre Henrique dos Reis-Prado
- Department of Restorative Dentistry, School of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte 31270-901, Brazil
- Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI 48104, USA
| | - Tulio Morandin Ferrisse
- Department of Diagnosis, Surgery and Oral Medicine, School of Dentistry, São Paulo State University (UNESP), Araraquara 14801-385, Brazil;
| | - Evandro Barbosa dos Anjos
- Department of Medicine, Institute of Health Sciences (ICS), United Colleges of Northern Minas (FUNORTE), Montes Claros 39404-006, Brazil
| | - Maria Helena Fernandes
- Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, University of Porto, 4160-007 Porto, Portugal
- Associated Laboratory for Green Chemistry—LAQV/REQUIMTE, University of Porto, 4050-453 Porto, Portugal
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Han S, Choi HY, Kim YH, Choi S, Kim S, Nam JY, Kim B, Song GS, Lim HS, Bae KS. Comparison of Pharmacodynamics between Tegoprazan and Dexlansoprazole Regarding Nocturnal Acid Breakthrough: A Randomized Crossover Study. Gut Liver 2023; 17:92-99. [PMID: 36317518 PMCID: PMC9840922 DOI: 10.5009/gnl220050] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 06/17/2022] [Accepted: 06/29/2022] [Indexed: 01/14/2023] Open
Abstract
Background/Aims Tegoprazan, a novel potassium-competitive acid blocker, is expected to overcome the limitations of proton pump inhibitors and effectively control nocturnal acid breakthrough. To evaluate the pharmacodynamics of tegoprazan versus dexlansoprazole regarding nocturnal acid breakthrough in healthy subjects. Methods In a randomized, open-label, single-dose, balanced incomplete block crossover study, 24 healthy male volunteers were enrolled and randomized to receive oral tegoprazan (50, 100, or 200 mg) or dexlansoprazole (60 mg) during each of two administration periods, separated by a 7- to 10-day washout period. Blood samples were collected for pharmacokinetic parameter analysis; gastric monitoring was performed for pharmacodynamic parameter evaluation. Results All 24 subjects completed the study. Average maximum plasma concentration, area under the plasma concentration-time curve, and mean time with gastric pH >4 and pH >6 for tegoprazan demonstrated dose-dependent incremental increases. All the tegoprazan groups reached mean pH ≥4 within 2 hours, whereas the dexlansoprazole group required 7 hours after drug administration. Based on pharmacodynamic parameters up to 12 hours after evening dosing, 50, 100, and 200 mg of tegoprazan presented a stronger acid-suppressive effect than 60 mg of dexlansoprazole. Moreover, the dexlansoprazole group presented a comparable acid-suppressive effect with the tegoprazan groups 12 hours after dosing. Conclusions All the tegoprazan groups demonstrated a significantly faster onset of gastric pH increase and longer holding times above pH >4 and pH >6 up to 12 hours after evening dosing than the dexlansoprazole group.
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Affiliation(s)
- Sungpil Han
- Department of Pharmacology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hee Youn Choi
- Department of Clinical Pharmacology and Therapeutics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yo Han Kim
- Department of Clinical Pharmacology and Therapeutics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - SeungChan Choi
- Department of Clinical Pharmacology and Therapeutics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seokuee Kim
- Clinical Development, HK inno.N Corp., Seoul, Korea
| | - Ji Yeon Nam
- Clinical Development, HK inno.N Corp., Seoul, Korea
| | - Bongtae Kim
- Clinical Development, HK inno.N Corp., Seoul, Korea
| | | | - Hyeong-Seok Lim
- Department of Clinical Pharmacology and Therapeutics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyun-Seop Bae
- Department of Clinical Pharmacology and Therapeutics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea,Corresponding AuthorKyun-Seop Bae, ORCIDhttps://orcid.org/0000-0001-7399-5879, E-mail
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Mahoney LB, Rosen R. The Spectrum of Reflux Phenotypes. Gastroenterol Hepatol (N Y) 2019; 15:646-654. [PMID: 31892911 PMCID: PMC6935024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The focus on a symptom-based definition for gastroesophageal reflux disease (GERD) in adults and children has contributed to widespread use of acid suppression medications in patients with so-called typical reflux symptoms to treat the possibility of acid-mediated disease. Diagnostic testing with upper endoscopy, esophageal biopsies, ambulatory reflux monitoring, and/or esophageal manometry is often pursued when patients do not respond optimally to these medications. By using information from this diagnostic testing, GERD has shifted from a single diagnosis to a phenotypic spectrum, and each phenotype has unique pathophysiologic mechanisms driving symptom perception. Understanding these mechanisms is important to tailor individualized treatment plans and guide therapeutic interventions. The aim of this article is to discuss the different reflux phenotypes, the utility of esophageal reflux testing, the mechanisms underlying symptoms, and the management strategies for each phenotype.
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Affiliation(s)
- Lisa B Mahoney
- Dr Mahoney is an instructor in pediatrics and Dr Rosen is an associate professor of pediatrics at Harvard Medical School in Boston, Massachusetts, as well as in the Motility and Functional Gastrointestinal Disorders Center and the Division of Gastroenterology, Hepatology and Nutrition at Boston Children's Hospital in Boston, Massachusetts
| | - Rachel Rosen
- Dr Mahoney is an instructor in pediatrics and Dr Rosen is an associate professor of pediatrics at Harvard Medical School in Boston, Massachusetts, as well as in the Motility and Functional Gastrointestinal Disorders Center and the Division of Gastroenterology, Hepatology and Nutrition at Boston Children's Hospital in Boston, Massachusetts
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Niu CY, Zhou YS, Wu FX. Individualized medicine of gastroesophageal reflux disease. Shijie Huaren Xiaohua Zazhi 2018; 26:2046-2056. [DOI: 10.11569/wcjd.v26.i35.2046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Gastroesophageal reflux disease (GERD) is a common disease worldwide, and its prevalence is increasing in both developed and developing countries. GERD is divided into three subtypes, namely, erosive esophagitis, nonerosive reflux disease (NERD), and Barrett's esophagus. The etiology, pathogenesis, clinical manifestations, and response to treatment of GERD invariably show high heterogeneity or significant individual difference, especially NERD and refractory GERD. On the other hand, advanced technology has currently provided a wide range of methods for the diagnosis and treatment of GERD patients; however, the long-term efficacy and quality of life of some patients are unsatisfactory. Therefore, each GERD patient needs a specialized management strategy aiming at his/her own condition, which is known as individualized medicine or personalized medicine. The goal of GERD treatment is to relieve the symptoms, while symptomatic remission is directly related to the quality of life. In other words, health-related quality of life and patient satisfaction may be reasonable criteria for GERD. In this paper, we will discuss the individualized medicine of GERD.
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Affiliation(s)
- Chun-Yan Niu
- Department of Gastroenterology, Xiang'an Hospital, Xiamen University, Xiamen 361101, Fujian Province, China
| | - Yong-Shun Zhou
- Department of Gastroenterology, Xiamen University Hospital, Xiamen 361005, Fujian Province, China
| | - Fang-Xiong Wu
- Department of Gastroenterology, the First Affiliated Hospital of Xi'an Medical College, Xi'an 710077, Shaanxi Province, China
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Bardou M, Fortinsky KJ, Chapelle N, Luu M, Barkun A. An update on the latest chemical therapies for reflux esophagitis in children. Expert Opin Pharmacother 2018; 20:231-239. [DOI: 10.1080/14656566.2018.1549224] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Marc Bardou
- Centre d’Investigations Cliniques CIC1432, CHU de Dijon, Dijon Cedex, France
- Gastroenterology Department, CHU de Dijon, Dijon Cedex, France
| | - Kyle J. Fortinsky
- Department of Medicine, University of Toronto, Toronto General Hospital, Toronto, Ontario, Canada
| | | | - Maxime Luu
- Centre d’Investigations Cliniques CIC1432, CHU de Dijon, Dijon Cedex, France
| | - Alan Barkun
- Gastroenterology department, McGill University Health Centre, Montréal, Québec, Canada
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