Pharmacological and Safety Profile of Dexlansoprazole: A New Proton Pump Inhibitor - Implications for Treatment of Gastroesophageal Reflux Disease in the Asia Pacific Region

Although gastroesophageal reflux disease is not as common in Asia as in western countries, the prevalence has increased substantially during the past decade. Gastroesophageal reflux disease is associated with considerable reductions in subjective well-being and work productivity, as well as increased healthcare use. Proton pump inhibitors (PPIs) are currently the most effective treatment for gastroesophageal reflux disease. However, there are limitations associated with these drugs in terms of partial and non-response. Dexlansoprazole is the first PPI with a dual delayed release formulation designed to provide 2 separate releases of medication to extend the duration of effective plasma drug concentration. Dexlansoprazole has been shown to be effective for healing of erosive esophagitis, and to improve subjective well-being by controlling 24-hour symptoms. Dexlansoprazole has also been shown to achieve good plasma concentration regardless of administration with food, providing flexible dosing. Studies in healthy volunteers showed no clinically important effects on exposure to the active metabolite of clopidogrel or clopidogrel-induced platelet inhibition, with no dose adjustment of clopidogrel necessary when coprescribed. This review discusses the role of the new generation PPI, dexlansoprazole, in the treatment of gastroesophageal reflux disease in Asia.

Comparison of noninvasive diagnostic tests for helicobacter pylori infection

Since the 13C-urea breath test [UBT] has become a highly reliable method for the noninvasive diagnosis of Helicobacter pylori infection, this study was performed in order to compare the sensitivity, specificity and accuracy among noninvasive tests including capsule UBT, conventional UBT and serology in the diagnosis of H. pylori infection. One hundred patients received capsule UBT, conventional UBT and gave blood samples for the diagnosis of H. pylori infection. Upper gastrointestinal endoscopy was performed in all patients. H. pylori infection was defined as the presence of a positive culture or positive results of both histology and rapid urease test [CLO test]. McNemar's test was used to determine the significance of differences among capsule UBT, conventional UBT and serology. Differences were considered significant at p < 0.05. According to the predefined criteria, the sensitivity, specificity, positive predictive value and negative predictive value of capsule UBT, conventional UBT and serology was 100, 95.7, 96.4 and 100%; 100, 85.1, 88.3 and 100%, and 90.6, 85.1, 82.7 and 88.9%, respectively. The accuracy of capsule UBT was higher than that of conventional UBT and serology [98 vs. 93 and 88%, respectively]. Capsule UBT had a similar ability for the detection of H. pylori infection compared with conventional UBT and serology [McNemar's test, p > 0.05]. According to our study, capsule UBT was highly accurate compared with other noninvasive tests including conventional UBT and serology. It could become a good alternative to endoscopy for the diagnosis of H. pylori infection