Rabeprazole is superior to omeprazole for the inhibition of peptone meal‐stimulated gastric acid secretion in Helicobacter pylori‐negative subjects

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Abstract
Summary: Background: Peptone meal‐stimulated gastric acid output is considered to be a reliable means to evaluate drug‐mediated inhibition of stimulated gastric acid output, an important measure of the efficacy of the agents — such as proton pump inhibitors — used to treat acid‐related disorders.Aim: To compare the initial and overall inhibitory effects on peptone meal‐stimulated gastric acid secretion of rabeprazole and omeprazole, 20 mg, in Helicobacter pylori‐negative subjects on the first and eighth days of treatment.Methods: Healthy volunteers (n = 27) were randomized in a single‐centre, double‐blind, double‐dummy, 2 × 2 cross‐over study. Subjects received an oral dose of rabeprazole or omeprazole, 20 mg once daily, for 8 days. After a 2–4‐week washout period, subjects were crossed over to receive the other medication for 8 days. Peptone meal‐stimulated gastric acid secretion was measured at hours 11 and 23 at baseline and on days 1 and 8 of treatment.Results: On days 1 and 8, rabeprazole demonstrated a significantly greater inhibition of peptone meal‐stimulated gastric acid secretion compared with omeprazole at all time points (P < 0.03). Median values of steady‐state inhibition on day 1 were statistically significant at hour 23 (rabeprazole 100% vs. omeprazole 74%, P < 0.02).Conclusions: Rabeprazole, 20 mg, demonstrated superior control of peptone meal‐stimulated gastric acid secretion compared with omeprazole, 20 mg, after the first dose and after the eighth daily dose. Rabeprazole achieved a more rapid onset of acid inhibition and a greater steady‐state reduction in peptone meal‐stimulated gastric acid secretion.

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