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Medline ® Abstract for Reference 38

of 'Overview and comparison of the proton pump inhibitors for the treatment of acid-related disorders'

38
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Esomeprazole 20 mg on-demand is more acceptable to patients than continuous lansoprazole 15 mg in the long-term maintenance of endoscopy-negative gastro-oesophageal reflux patients: the COMMAND Study.
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Tsai HH, Chapman R, Shepherd A, McKeith D, Anderson M, Vearer D, Duggan S, Rosen JP, COMMAND Study Group
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Aliment Pharmacol Ther. 2004;20(6):657.
 
BACKGROUND: Symptom relief, through adherence to appropriate maintenance therapy, is the sole objective of treatment for patients with endoscopy-negative gastro-oesophageal reflux disease.
AIM: To compare the efficacy of 'on-demand' treatment with esomeprazole 20 mg vs. continuous treatment with lansoprazole 15 mg daily in patients with endoscopy-negative gastro-oesophageal reflux disease.
METHODS: Endoscopy-negative gastro-oesophageal reflux disease patients who achieved complete resolution of heartburn after short-term (2-4 weeks) treatment with esomeprazole 20 mg (n = 774) were randomized to receive either esomeprazole 20 mg on-demand (n =311) or lansoprazole 15 mg continuous daily treatment (n = 311) for 6 months.
RESULTS: Significantly more patients were willing to continue taking esomeprazole on-demand than lansoprazole continuous therapy after 6months (93% vs. 88%; P = 0.02). This superior outcome was achieved despite patients on esomeprazole requiring medication only 38% as often as those on lansoprazole, leading to direct cost savings of more than one-third (36%). Furthermore, patients receiving esomeprazole 20 mg on-demand were more satisfied with their treatment after 1 month compared with patients taking lansoprazole 15 mg continuously.
CONCLUSIONS: In patients with endoscopy-negative gastro-oesophageal reflux disease, esomeprazole 20 mg on-demand is more acceptable to patients and is an economically more effective treatment than lansoprazole 15 mg continuously.
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Castle Hill Hospital, Cottingham, Hull, UK. hhtsai@doctors.org.uk
PMID