Nexium comparative data provides further boost to AstraZeneca

AstraZeneca's new-generation proton pump inhibitor Nexium (esomeprazole)appears to have fulfilled its much-trumpeted potential as an advance in the management of acid-related gastrointestinal diseases. New clinical results presented at the United European Gastroenterology Week meeting in Amsterdam, the Netherlands, indicate that the drug is superior to rival PPI Prevacid (lansoprazole), originally developed by Japanese firm Takeda, in the healing of reflux esophagitis.

The head-to-head study compared Nexium 40mg with the standard 30mg dose of lansoprazole in 5,241-patients with endoscopically-documented erosive esophagitis. The results showed that the AstraZeneca drug healed significantly more patients at four and eight weeks, with the onset of sustained resolution of heartburn occurring faster (seven days vs eight days). In addition, the onset of sustained nocturnal symptom resolution occurred in just one day with Nexium, and after two days with lansoprazole. All of these differences were statistically significant.

Notably, higher rates of healing were seen with the new PPI for all patients with the disorder, including those with more severe tissue damage, compared to lansoprazole. In contrast, the efficacy of the latter drug tended to decline with increasing disease severity. Historical data suggest that around 20%-30% of patients have more severe forms of the disease at presentation to the physician, but this is often not apparent from their symptoms and can only be determined with endoscopy, which is not routinely employed.