Comparison of the Efficacy of Dexrabeprazole and Rabeprazole in Inhibiting Intragastric and Intraesophageal Acidity in Gastroesophageal Reflux Disease.

Background

Proton pump inhibitors (PPIs) are the cornerstone of gastroesophageal reflux disease (GERD) treatment, but concerns regarding their efficacy and side effects persist. Dexrabeprazole, the R(+) enantiomer of rabeprazole, may offer similar efficacy with a lower dose, potentially addressing these issues.

Aim

This study aimed to compare the efficacy and safety of dexrabeprazole 10 mg and rabeprazole 20 mg in GERD patients with pathologic acid reflux.

Method

A total of 48 GERD patients were included: 24 received dexrabeprazole 10 mg and 24 constituted the historical active-control group receiving rabeprazole 20 mg, once daily for 7 days. Gastric and intraesophageal acidity, GERD symptoms (heartburn, regurgitation), and adverse event frequency were assessed pre- and post-treatment.

Results

Both groups showed significant improvements in esophageal and gastric acidity, acid reflux frequency, and GERD symptoms. Dexrabeprazole 10 mg significantly reduced regurgitation scores by day 1 (P=0.001), whereas rabeprazole 20 mg did not achieve similar reductions at this time point (P=0.114). In addition, the reduction in 24-hour intraesophageal pH <4 times was greater in the dexrabeprazole group (P=0.035). There were no significant differences in adverse events or laboratory findings between groups.

Conclusion

Dexrabeprazole 10 mg demonstrated comparable efficacy to rabeprazole 20 mg and provided faster improvement in regurgitation and a greater reduction in intraesophageal acid exposure. These findings suggest that dexrabeprazole 10 mg may be an effective alternative to higher doses of rabeprazole in GERD management. Further studies are warranted to confirm these results and explore their long-term benefits.