[All proton pump inhibitors are equally efficacious in standard dosages]

Proton pump inhibitors (PPIs) are today used at different recommended doses for treatment of acid-related gastro-esophageal, gastric and gastro-duodenal diseases. We reviewed the literature regarding inhibition of acid secretion and healing rates for the different PPIs. Acid secretion in vitro and in vivo as well as healing and relapse rates were similar on a milligram basis for omeprazole, lansoprazole, rabeprazole, and pantoprazole. Rabeprazole had a somewhat faster onset of inhibition of acid secretion; the clinical value of this however seems limited. Esomeprazole had a somewhat stronger inhibitory effect on acid secretion in vivo compared with other PPIs. Studies demonstrating an important clinical advantage of esomeprazole compared to other PPIs are however lacking.