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Equine veterinary journal2023; doi: 10.1111/evj.13997

Comparison of oral esomeprazole and oral omeprazole in the treatment of equine squamous gastric disease.

Abstract: Oral omeprazole is the accepted treatment for equine squamous gastric disease (ESGD); however, it is not universally effective. Esomeprazole results in more consistent and pronounced acid suppression in men and is more effective than omeprazole in the treatment of oesophageal and gastric disease. Pharmacodynamic and pilot clinical studies have indicated esomeprazole might also be more effective than omeprazole in horses. Objective: To compare the efficacy and safety of oral esomeprazole and omeprazole pastes in the treatment of ESGD and, where present, concurrent equine glandular gastric disease (EGGD). Methods: Randomised, single-blinded controlled trial. Methods: Horses presenting with grade ≥2 ESGD lesions were randomly allocated to receive 4 mg/kg of either a buffered esomeprazole or omeprazole paste orally once daily for 28 days before gastroscopy being repeated within a further 3 days. Videos and images were anonymised and subsequently graded blind by one researcher. The severity of ESGD (and EGGD) lesions before and after treatment, and thereby treatment responses, were compared using univariable logistic regression. Results: A higher proportion of horses had ESGD healing in response to esomeprazole treatment (63/74, 85%) than with omeprazole treatment (43/73, 59%) (odds ratio [OR]: 4.00, 95% confidence interval [CI]: 1.81, 8.82, p = 0.001). In a subset of horses that had concurrent EGGD, a greater proportion of the horses treated with esomeprazole had lesions ≤grade 1 (esomeprazole 28/51, 55%; omeprazole 6/24, 25%; OR: 3.65, 95% CI: 1.25, 10.71, p = 0.02) Using grade 0 as the benchmark for EGGD healing, the difference remained significant (OR: 4.44, 95% CI: 1.33, 14.85, p = 0.02). Conclusions: It may not be possible to extrapolate these results to other populations with different signalment or management. Conclusions: Oral-buffered esomeprazole was a more effective treatment for ESGD (and concurrent EGGD) than oral-buffered omeprazole. Unassigned: Oral verabreichtes Omeprazol ist die akzeptierte Behandlungsform von Equine Squamous Gastric Disease (ESGD); allerdings ist es nicht universell effektiv. Esomeprazol resultiert in konsistenterer und ausgeprägter Säuresuppression beim Menschen und ist effektiver als Omeprazol in der Behandlung von Ösophageal- und Magenerkrankungen. Pharmakodynamische und klinische Pilotstudien ließen erkennen, dass Esomeprazol auch bei der Behandlung von Pferden effektiver ist als Omeprazol. Unassigned: Vergleich der Effektivität und Sicherheit oraler Esomeprazol- und Omeprazolpasten bei der Behandlung ESGD, und, falls vorhanden, zeitgleich auftretendem Equine Glandular Gastric Disease (EGGD). Methods: Randomisierte, einfach verblindete Fallkontrollstudie. Methods: Pferde mit Grad ≥2 ESGD Läsionen wurden zufällig einer Behandlung mit 4 mg/kg gepufferter Esomeprazol- oder Omeprazolpaste zugewiesen, oral verabreicht SID für 28 Tage bevor eine Gastroscopie innerhalb weiterer 3 Tage wiederholt wurde. Videos und Bilder wurden anonymisiert und anschließend von einem geblendeten Autor gradiert. Der Schweregrad der ESGD (und EGGD) Läsionen vor und nach Behandlung, und damit Ansprechen auf die Behandlung, wurden mithilfe der univariablen logistischen Regression verglichen. Unassigned: Ein größerer Anteil an Pferden zeigte ESGD-Abheilung als Reaktion auf die Behandlung mit Esomeprazol (63/74, 85%) im Vergleich zu der Behandlung mit Omeprazol (43/73, 59%; OR:4.00, 95%CI:1.81, 8.82, p = 0.001). Ein größerer Anteil einer Teilmenge der Pferde mit simultanem EGGD, welche mit Esomeprazol behandelt wurden, hatte Läsionen ≤ Grad 1 (Esomeprazol 28/51, 55%; Omeprazol 6/24, 25%; OR: 3.65, 95%CI: 1.25, 10.71, p = 0.02). Wenn Grad 0 als Bezugsgröße für EGGD-Abheilung verwendet wurde, blieb der Unterschied signifikant (OR: 4.44, 95%CI: 1.33, 14.85, p = 0.02). HAUPTEINSCHRÄNKUNGEN: Es ist möglicherweise nicht möglich, diese Resultate auf andere Populationen mit abweichendem Signalement oder Management zu extrapolieren. Unassigned: Die orale Verabreichung von gepuffertem Esomeprazol war effektiver für die Behandlung von ESGD (und zeitgleich auftretendem EGGD) als die orale Verabreichung von gepuffertem Omeprazol.
© 2023 The Authors. Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
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Publication Date: 2023-09-07 PubMed ID: 37678812DOI: 10.1111/evj.13997Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This study reveals that oral-buffered esomeprazole is more effective than oral-buffered omeprazole in the treatment of equine squamous gastric disease (ESGD) and concurrent equine glandular gastric disease (EGGD).

Research Objectives and Methods

  • This research aimed to compare the efficacy and safety of esomeprazole and omeprazole pastes in treating ESGD and, when present, concurrent EGGD. Both drugs are used in treating gastric diseases, but esomeprazole has shown more consistent, pronounced effects on acid suppression. Therefore, the study hypothesized that esomeprazole might be more effective in horses too.
  • The method involved a randomized and single-blinded controlled trial. Horses with grade ≥2 ESGD lesions were treated with either a buffered esomeprazole or omeprazole paste, orally once daily for 28 days. Gastroscopy was then repeated within three days of the treatment. Treatment responses were compared using univariable logistic regression.

Research Findings

  • The study found that a higher proportion of horses had ESGD healing when treated with esomeprazole (85%) than with omeprazole (59%).
  • When EGGD was concurrently present, there was a greater proportion of horses treated with esomeprazole that showed lesions ≤grade 1 (55%) when compared to omeprazole-treated ones (25%), signifying a better healing response with esomeprazole.
  • When grade 0 was considered as the benchmark for EGGD healing, the difference in treatments remained significant, with esomeprazole treated horses faring better.

Conclusion and Implications of the Study

  • The results showed oral-buffered esomeprazole to be a more effective treatment option for ESGD and concurrent EGGD in horses, compared to oral-buffered omeprazole. This could change the approaches to treating these conditions, rendering better health outcomes for horses.
  • However, the study indicates the results may not be applicable or extrapolated to other populations due to difference in signalment or management. This implies that it’s necessary to take into account the specific circumstances and characteristics of other populations in subsequent studies or clinical application.

Cite This Article

APA
Sundra T, Gough S, Rossi G, Kelty E, Rendle D. (2023). Comparison of oral esomeprazole and oral omeprazole in the treatment of equine squamous gastric disease. Equine Vet J. https://doi.org/10.1111/evj.13997

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English

Researcher Affiliations

Sundra, Tania
  • Avon Ridge Equine Veterinary Services, Brigadoon, Western Australia, Australia.
Gough, Sarah
  • Hunter Equine Centre, Scone, New South Wales, Australia.
Rossi, Gabriele
  • School of Veterinary and Biomedical Sciences, Murdoch University, Murdoch, Western Australia, Australia.
Kelty, Erin
  • School of Population and Global Health, The University of Western Australia, Crawley, Western Australia, Australia.
Rendle, David
  • EMT Consulting, Devon, UK.

Grant Funding

  • Luoda Pharma

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