Pantoprazole, an effective treatment for gastro-oesophageal reflux disorder

Recent studies indicate that Somac is effective in treating gastro-oesophageal reflux disorder, a common condition resulting in damage to the oesophageal mucosa.

Gastro-oesphogeal reflux disease (GORD) is fairly common with up to 25% of the adult population suffering from it and 3% are severe cases.¹ Proton pump inhibitors are used to treat GORD as they prevent the secretion of gastric acid.² Pantoprazole (somac) can be administered intravenously or orally.³ It is an effective treatment for GORD by blocking the gastric acid secretion pump as it has a longer duration of action⁴and provides faster symptomatic relief.⁵ Pantoprazole can be used over a long period of time (studies have shown up to 5 years).⁶ Several studies have focussed on this drug and it has since been found to be an effective, safe and easily administered treatment for GORD.

A study conducted in 2000 found that a 40mg dose of pantoprazole is the most effective dose to treat GORD.¹ Relatively few side effects were associated with this dose and it also provided rapid symptomatic relief compared to a placebo.¹ In another study published in 2004 in the Ailment Phamacology Therapies Journal, pantoprazole was shown to be more effective than rantitidine (histamine-2 receptor antagonist).² This is thought to be because pantoprazole does not act on the receptor site itself but further downstream and prevents gastric acid secretion.² As a result, pantoprazole can provide symptomatic relief of GORD regardless of the original stimulus.²

Furthermore, pantoprazole has been shown to be more effective than other proton pump inhibitors at treating GORD.^4,5 One study conducted showed that pantoprazole provided faster symptomatic relief (two days earlier) than esomeprazole during the day and night.⁵ Both esomeprazole and pantoprazole provided a similar reduction in the symptoms of GORD.⁵ Pantoprazole was also shown to have a longer duration of action compared to another proton pump inhibitor, omeprazole.⁴ This is thought to be due to differences in binding to the cysteine residues on the receptor.⁴ Omeprazole is thought to bind reversibly to both cysteine 813 and 892 whereas pantoprazole binds reversibly to cysteine 813 but binds irreversibly to cysteine 822.⁴ Consequently, pantoprazole will have a longer period of action as it represses gastric acid secretion for an extended period of time as it will take longer for the drug to be removed from its site of action.⁴

Long term use of pantoprazole has not been shown to be harmful at the recommended dosing levels.⁶ Studies have shown that 40mg doses of pantoprazole over a period fo five years have not been detrimental to the individual.⁶

References:

Richter JE, Bochenek W and the Prantopazol US GERD Study Group. Oral Pantoprazole for Erosive Esophagitis: A Placebo-Controlled, Randomized Clinical Trial. The American Journal of Gastroenterology 2000 95(11) 3071-3080
Richter JE, Fraga P and Mack M et al. Prevention of erosive oesophagitis relapse with pantoprazole. Ailment Pharmacol Ther 2004; 20: 567-575
Somac Injection, MIMS database [online] Last Updated: 30/11/2006. Available from: URL: http://mims.hcn.net.au
Shin JM, Sachs G. Differences in binding properties of two proton pump inhibitors on the gastric H⁺, K⁺-ATPase in vivo. Biochemical Pharmacology 2004 68: 2117-2127
Scholten T, Gatz G and Hole U. Once-daily pantoprazole 40mg and esomeprazole 40mg have equivalent overall efficacy in relieving GERD-related symptoms. Ailment Phamacol Ther 2003; 18: 597-594
Bardhan KD, Bishop AE, Polak JM et al. Pantoprazole in severe acid-peptic disease: the effectiveness and safety of 5 years’ continuous treatment. Digestive and Liver Disease 2005; 37: 10-22