BACKGROUND: Increased BMI is associated with a higher risk of gastroesophageal reflux disease.
OBJECTIVE: To investigate whether overweight/obesity (BMI≥25 kg/m(2)) affects
rabeprazole clinical efficacy versus omeprazole in patients with erosive esophagitis (EE).
METHODS: Post-hoc analysis of EE healing rate and symptom response stratified by patient BMI was performed on data from a multicenter, double-blind, randomized, 4-to-8-week trial comparing EE healing with
rabeprazole (20 mg daily) and omeprazole (20 mg daily). Analysis of variance, two-sample t-test, Blackwelder\'s test for equivalence, log-rank, and Cochran-Mantel-Haenszel tests were used to analyze comparisons.
RESULTS: In the two BMI groups (<25 kg/m(2) and ≥25 kg/m(2) respectively),
rabeprazole and omeprazole were equally effective for mucosal healing regardless of patient\'s BMI (N=542, P>0.05). However, in overweight/obese patients,
rabeprazole was significantly faster than omeprazole in inducing heartburn relief during the first treatment week (P<0.0001).
CONCLUSIONS: Results of this study show that the clinical efficacy of
rabeprazole is maintained in overweight/obese patients with gastroesophageal reflux disease and suggest that this subgroup of patients may derive, from rabeprazole, even greater benefit than lean patients.