Jorge Gonzalez

Efficacy and safety of oral pantoprazole 20 mg given once daily for reflux esophagitis in children.

OBJECTIVESnTo investigate the efficacy and safety of oral pantoprazole, 20 mg (0.5 to 1.0 mg/kg/day) once daily for 28 days, in pediatric patients with reflux esophagitis.nnnMETHODSnPatients in this study (n = 15; 6 to 13 years old, 9 boys) had reflux esophagitis grade Ic or II (Vandenplas classification). The efficacy of pantoprazole to reduce esophageal acid exposure time (pH < 4), reduce the number and duration of reflux episodes, and to increase the percentage of time with gastric pH > 3 was assessed by continuous 24-hour pH monitoring. The intensity of 5 common symptoms of esophagitis was scored before and after treatment on a 4-point scale. Esophagitis was assessed at baseline and after treatment by visual inspection and by the histology of biopsies from the distal third of the esophagus.nnnRESULTSnBefore treatment, the median percentage of time with intra-esophageal pH <4 was 9.3%. After 28 days of therapy with pantoprazole, this value decreased to 2.7% (P = 0.0006). The median percentage of time with intragastric pH > 3 increased from 21% at baseline to 39% on day 28 of therapy (P = 0.005). After 28 days of treatment, all patients experienced at least partial relief from reflux symptoms. Endoscopically confirmed healing of esophagitis was seen in 47% of children (Savary-Miller classification). Histologic evidence of healing was not observed. Median serum gastrin levels were slightly elevated over baseline levels (from 74 pg/ml to 93 pg/ml). In one patient there was a transient elevation of serum GOT and GPT during treatment.nnnCONCLUSIONSnOral pantoprazole 20 mg daily provided gastric acid control in 15 pediatric patients with reflux esophagitis with partial clinical improvement of symptoms after 28 days of treatment. Pantoprazole was safe and well tolerated.

S1098 Symptoms Improvement Evaluation in GERD Patients: Assessed Independently By a Physicians and Patients Using the Request Questionnaire Before and After Pantoprazole Magnesium 40mg o.d. for 28 Days Treatment

eructs, and halitosis), UA (upper abdominal discomfort, early satiety, postprandial fullness, nausea and flatulence), EX (non-cardiac chest pain, disnea, chronic cough, hoarseness, sleep disturbances). Scores from the extracted variance (UA 48%, ES 40%, EX 46%) were used in a general linear model (GLM) adjusted by geographical distribution, medical specialty, age, sex, BMI, severity of heartburn and regurgitation. RESULTS: Severities of ES, UA, and EX symptoms were positively associated with the severity of heartburn and regurgitation. EX symptoms scores were higher in the NS group compared with diurnal complains group (p<0.001), but for UA, the symptoms score was higher in the diurnal group (p<0.03). We tested the effect of NS over ES, UA and EX scores using a GLM for repeated measurements (adjusted by geographical distribution, medical specialty, age, sex, and BMI). Improvements in the scores for all symptoms were found after treatment with PMg. The EX symptoms in NS group had particularly relevant improvement (p<0.001). CONCLUSIONS: PMg showed an important improvement for all symptoms scores. This effect was markedly superior for EX symptoms in the NS group.