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Ilaprazole: Is this a superior proton pump inhibitor for duodenal ulcer?
N P Bohidar1, K Krishna2, B K Panda3
1Gastroenterology and Hepatology, Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, West Bengal, India. nbohidar@hotmail.com
Background:
Preclinical studies have found ilaprazole to be significantly effective in preventing the development of reflux oesophagitis and gastric secretion in a dose-dependent manner; the drug also has a broad dose range and safety feature. Till date only one clinical study on patients with gastro-oesophageal reflux disease has shown its potency in suppressing gastric acid secretion.
Objectives:
To review the published randomized controlled trials (RCTs) assessing the efficacy of ilaprazole in duodenal ulcer (DU) compared to other available proton pump inhibitors (PPI).
Methods:
RCTs comparing ilaprazole with other PPIs in DU were searched in the PubMed and Cochrane Library database using the term 'ilaprazole and duodenal ulcer'. All clinical studies showing effectiveness of ilaprazole in patients with DU, either full texts or scientific abstracts and found to be potentially eligible for the systematic review, were included and evaluated.
Results:
Four RCTs having follow-up data were included. A total of 1077 patients with DU were assessed. All the trials had included omeprazole as a comparator PPI. The majority of patients (80%) became asymptomatic after treatment in both the groups. None of the trials data predict ilaprazole to be superior to omeprazole in terms of efficacy in patients with DU.
Conclusion:
The trials conducted were limited in numbers and all the trial data indicated the efficacy of ilaprazole to be similar to that of omeprazole. None of the trials indicated superiority of ilaprazole over the existing PPIs.
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