Rabeprazole and esomeprazole in mild-to-moderate erosive gastroesophageal reflux disease: A comparative study of efficacy and safety

Core-shell tablets designed for modified and sequential release of ibuprofen and rabeprazole

In this study, core-shell tablets comprising an ibuprofen (IBU) enteric-coated core for modified release and a rabeprazole (RAB) shell for immediate release were developed using wet granulation method. The primary aim was to produce a sequential release of RAB and IBU with pharmacokinetic profiles comparable to those of the respective single tablets, thereby reducing the potential for IBU-associated gastrointestinal (GI) side effects. The composition of the IBU/RAB core-shell tablets was finalized on a comparative basis by evaluating various trial formulations. IBU/RAB core-shell tablets (400/20 mg) were assessed for physicochemical attributes, storage stability, and in vivo pharmacokinetics in beagle dogs. IBU/RAB core-shell tablets showed immediate RAB release (99.5 % in 1 h at pH 1.2) and delayed IBU release (3.4 % and 88 % in the acid and buffer stages, respectively). IBU/RAB core-shell tablets produced either comparable or improved plasma concentrations in dogs (Cmax; 1163.3 vs. 1160.0 ng/mL for RAB and 27,370 vs. 24,170 ng/mL for IBU) compared to those of the respective single tablets. The IBU/RAB core-shell tablets also demonstrated long-term and accelerated storage stability. In conclusion, the core-shell design could be a promising strategy for the co-administration and sequential release of IBU and RAB to relieve inflammatory conditions and reduce GI complications.

Efficacy and safety of rabeprazole in children (1-11 years) with gastroesophageal reflux disease

OBJECTIVE

Evaluate the efficacy and safety of rabeprazole in children, 1 to 11 years old, with endoscopically/histologically proven gastroesophageal reflux disease (GERD).

METHODS

Children were randomized to 0.5- or 1.0-mg/kg rabeprazole granule formulation for 12 weeks. The dose was further determined by weight: children 6 to 14.9 kg (low-weight cohort) received 5 or 10 mg and children ≥15 kg (high-weight cohort) received 10 or 20 mg. The primary endpoint was endoscopic/histologic healing at week 12 (defined as grade 0 on the Hetzel-Dent classification scale and/or grade 0 on the Histological Features of Reflux Esophagitis scale).

RESULTS

Overall, 81% (87/108) achieved endoscopic/histologic healing at week 12 with higher healing in the low-weight cohort (82% [5-mg dose], 94% [10-mg dose]) compared with high-weight cohort (76% [10-mg dose], 78% [20-mg dose]). There was a significant (P < 0.001) decrease in the mean Total GERD Symptoms and Severity score from 19.7 points (baseline) to 8.6 points (week 12), with 26% fewer children reporting GERD symptoms at week 12. The average frequency of symptoms per child decreased from 7.7 (week 1) to 4.7 (week 12). The GERD Symptom Relief score showed that 71% of children felt better, 81% were rated "good to excellent" on the Global Treatment Satisfaction scale by the investigator; 77% were rated "good to excellent" on the Clinical Global Impressions-Improvement scale by the parent/caregiver. The most common (>10%) treatment-emergent adverse events included cough and vomiting (14% each), abdominal pain (12%), and diarrhea (11%).

CONCLUSIONS

Rabeprazole was effective and safe in 1- to 11-year-old children with GERD.

The effect of rabeprazole on LES tone in experimental rat model

INTRODUCTION

Despite adequate treatment with proton pump inhibitors (PPIs), symptoms of gastroesophageal reflux disease (GERD) may remain persistent as well as Barrett's esophagus may emerge. It may be proposed that the relaxant effect of PPIs on the smooth muscles may lead to resistance of symptoms. The aim of this study is to investigate effects of rabeprazole on the lower esophageal sphincter (LES) pressure with a rat model.

MATERIALS AND METHODS

Sixteen rats were grouped as control and treatment groups. After obtaining LES tissues followed by a 60 min equilibration period for stabilization, contractile response to carbachol was obtained by application of single dose of carbachol to have a final concentration of 10(-6) M in the organ bath. After the contractions reached a plateau, concentration-response relationships for rabeprazole were obtained in a cumulative manner in the treatment group.

RESULTS

In the carbachol contracted LES preparations; 1.5 × 10(-6) and 1.5×10(-5) M of rabeprazole caused 6.08% and 11.34% relaxations respectively which were not statistically significant. However, mean integral relaxation value for 4.5 × 10(-5) M of rabeprazole was 17.34% and this relaxation was significant compared with controls.

CONCLUSIONS

In the present study, rabeprazole caused no direct significant change in LES tone in the therapeutic dose range applied to the organ bath. However, rabeprazole at the high dose caused a significant decrease in the LES tone.