Does BMI affect the clinical efficacy of proton pump inhibitor therapy in GERD? The case for rabeprazole

作者：Pace Fabio; Coudsy Bogdana; DeLemos Byron; Sun Yijun; Xiang Jim; LoCoco John; Casalini Stefania; Li Honglan; Pelosini Iva; Scarpignato Carmelo^*

来源：European Journal of Gastroenterology and Hepatology, 2011, 23(10): 845-851.

DOI：10.1097/MEG.0b013e32834991b7

• body mass index
• erosive esophagitis
• obesity
• proton pump inhibitors
• rabeprazole

Background Increased BMI is associated with a higher risk of gastroesophageal reflux disease.
Aims To investigate whether overweight/obesity (BMI >= 25 kg/m(2)) affects rabeprazole clinical efficacy versus omeprazole in patients with erosive esophagitis (EE).
Patients and methods Post-hoc analysis of EE healing rate and symptom response stratified by patient BMI was performed on data from a multicenter, double-blind, randomized, 4-to-8-week trial comparing EE healing with rabeprazole (20mg daily) and omeprazole (20mg daily). Analysis of variance, two-sample t-test, Blackwelder's test for equivalence, log-rank, and Cochran-Mantel-Haenszel tests were used to analyze comparisons.
Results In the two BMI groups (< 25 kg/m(2) and >= 25 kg/m(2) respectively), rabeprazole and omeprazole were equally effective for mucosal healing regardless of patient's BMI (N=542, P > 0.05). However, in overweight/obese patients, rabeprazole was significantly faster than omeprazole in inducing heartburn relief during the first treatment week (P < 0.0001).
Conclusions Results of this study show that the clinical efficacy of rabeprazole is maintained in overweight/obese patients with gastroesophageal reflux disease and suggest that this subgroup of patients may derive, from rabeprazole, even greater benefit than lean patients.

• 出版日期2011-10