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Esomeprazole more effective than famotidine in upper GI bleeding study
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Esomeprazole prevented upper gastrointestinal bleeding and other adverse events in patients with acute coronary syndrome or myocardial infarctions, according to study results.
Researchers administered either 20 mg esomeprazole or 40 mg famotidine daily for 4 to 52 weeks to participants with upper gastrointestinal complications due to treatment with aspirin, clopidogrel and enoxaparin or thrombolytics. The double blind, randomized, controlled trial included 163 patients in the esomeprazole group and 148 in the famotidine group.
After a mean follow-up of 19.2 weeks in the esomeprazole group and 17.6 weeks in the famotidine group, one participant in the esomeprazole group (0.6%) and nine in the famotidine group (6.1%) had experienced upper gastrointestinal bleeding (HR=0.095; 95% CI, 0.005-0.504). Occult bleeding of an unknown origin was experienced by one patient in the esomeprazole group and 11 (7.4%) in the famotidine group. (HR=0.077; 95% CI, 0.004-0.398). Major adverse events occurred in 4.3% of patients in the esomeprazole group and in 3.4% of the famotidine group (P=.7788), and included CV-related death, recurrent myocardial infarction and stroke.
“Esomeprazole was superior to famotidine in preventing upper gastrointestinal complications,” the researchers wrote. “Further randomized, controlled studies are required to determine the effect of [proton pump inhibitor] treatment on major adverse CV events in these patients treated with a combination of aspirin and clopidogrel, anticoagulant or thrombolytics.”
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