Effect of a single oral dose of rabeprazole on nocturnal acid breakthrough and nocturnal alkaline amplitude

Abstract

Aim: To study the effect of rabeprazole (RAB) on nocturnal acid breakthrough (NAB) and nocturnal alkaline amplitude (NAKA) and to compare it with omeprazole (OME) and pantoprazole (PAN).

Methods: By an open comparative study, forty patients with active peptic ulcer were randomly assigned to receive one of the three PPIs (proton pump inhibitor) with a single oral dose. They were divided into RAB group (10 mg), OME group (20 mg) and PAN group (40 mg). Twenty healthy volunteers were enrolled to the control group (without taking any drug). Intragastric pH monitoring was then performed 1 hour before and 24 hours after the dose was given.

Results: No clinically undesirable signs and symptoms possibly attributed to the administration of RAB or OME and PAN were recognizable throughout the study period. All subjects completed the study according to the protocol. All data were processed by a computer using the Student t test or t' test followed by an analysis of covariance. P<0.05 was considered to have statistical significance. The intragastric pH of NAB was significantly higher in RAB group (1.84+/-0.55) than in either OME group (1.15+/-0.31) or PAN group (1.10+/-0.30) (both P<0.01). RAB produced a longer sustaining time (4.65+/-1.22 h) on NAKA than OME (3.22+/-1.89 h) (P<0.05), PAN (3.15+/-1.92 h) (P<0.05), and the sustaining time of NAKA in RAB group was longer than that in the healthy control group (P<0.01) too. In addition, RAB produced a much higher pH on NAKA (6.41+/-0.45) in comparison with PAN (6.01+/-0.92) (P<0.05).

Conclusion: A single oral dose of 10 mg RAB may increase the pH of NAB and shorten the sustaining time of NAB, and it may increase the pH of NAKA as well as prolong the sustaining time of NAKA.

Figure 1

Simulating figure of NAB and NAKA. NAB and NAKA all occurred after midnight, and NAKA always appeared after NAB. Compared with the control group (didn’t receive either PPI or placebo), RAB increased the pH of NAKA as well as prolonged the persisting time of NAKA.