NEW YORK (Reuters Health) – The proton pump inhibitor dexlansoprazole modified release (MR) relieves nocturnal heartburn in patients with gastroesophageal reflux disease (GERD), study findings show. As a result, patients experience better sleep, less daytime impairment and improved quality of life.

A survey of more than 600 patients taking proton pump inhibitors, published in 2009, showed that 83% continued to have nocturnal heartburn that was often severe.

Dexlansoprazole MR (Dexilant, Takeda Pharmaceuticals) is an enantiomer of lansoprazole with a duel release mechanism that prolongs its duration of action following once-daily oral administration.

Dr. Ronnie Fass, from the Southern Arizona VA Health Care System in Tucson, and colleagues studied 305 patients (ages 18 to 66) with moderate to very severe, nonerosive GERD that had previously responded to acid-suppression therapy. They randomly assigned them to placebo (n = 153) or oral dexlansoprazole MR 30 taken once daily in the morning.

Their findings appear in the American Journal of Gastroenterology published online January 11th.

At baseline, 96% of patients reported 4 to 7 nights/week with heartburn. During the 4-week study, patients reported symptoms in daily electronic diaries.

The median percentage of nights free of heartburn dropped more in the dexlansoprazole MR group (73.1%) than in the placebo group (35.7%, p < .001).

The drug was more effective in patients with the most severe symptoms. For patients with mild to less than moderate nocturnal heartburn severity, the median percentage of nights without heartburn was 77.6% with placebo and 47.4% with dexlansoprazole MR. Corresponding values were 60.7% and 28.6% for those with moderate to less than severe symptoms, and 65.6% and 0% for those with severe to very severe symptoms.

The active drug was also associated with fewer nights with sleep disturbance due to GERD (median 11.1% vs 36.8%, p < .001) and more heartburn-free days (median 53.3% vs 14.3%, p < 0.001).

Based on questionnaire responses, patients taking dexlansoprazole MR reported better sleep quality, less severity and impact of nocturnal symptoms, and less impairment of work productivity and daily activities.

Dr. Fass