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Oral esomeprazole in Japanese pediatric patients with gastric acid-related disease: Safety, efficacy, and pharmacokinetics
- Source :
- Pediatrics international : official journal of the Japan Pediatric Society. 61(1)
- Publication Year :
- 2018
-
Abstract
- Background Proton pump inhibitors (PPI) are widely used for the treatment of gastric acid-related disease, but they are not approved for use in children in Japan. To assess the safety, pharmacokinetics, pharmacodynamics, and efficacy (gastrointestinal symptom improvement) of PPI in Japanese pediatric patients with gastric acid-related disease, we conducted an 8 week, open-label, parallel-group, multicenter, phase I/III study of once-daily oral esomeprazole use. Methods Japanese children, aged 1-14 years with gastric acid-related disease, were stratified by weight and age into five groups (10 patients/group) to receive esomeprazole as granules for suspension (10 mg) or capsules (10 mg or 20 mg) once daily. Results Esomeprazole was absorbed and eliminated rapidly in all groups, with a median time to reach maximum plasma concentration of 1.47-1.75 h, an arithmetic mean terminal elimination half-life of 0.80-1.37 h, and a weight-correlated apparent total body clearance of 0.216-0.343 L/h/kg. Area under the plasma concentration-time curve during a dosage interval and maximum plasma drug concentration were generally higher in groups given a higher dose (20 mg) or with a lower age/weight, but also in patients identified as poor metabolizers on cytochrome P450 2C19 genotype. Most patients who had any upper gastrointestinal symptoms at baseline were asymptomatic at the end of the study. Thirty-three patients (66%) reported ≥1 adverse events, including three patients who reported serious adverse events not judged to be causally related to esomeprazole. Conclusions Oral esomeprazole, at 10 mg or 20 mg once daily, had a similar safety, efficacy, and pharmacokinetic profile in Japanese pediatric patients to that previously seen in adults and Caucasian children.
- Subjects :
- Male
medicine.medical_specialty
Adolescent
Administration, Oral
Disease
CYP2C19
030204 cardiovascular system & hematology
Gastroenterology
Asymptomatic
Esomeprazole
Gastric Acid
03 medical and health sciences
0302 clinical medicine
Pharmacokinetics
Japan
030225 pediatrics
Internal medicine
medicine
Humans
Endoscopy, Digestive System
Adverse effect
Child
business.industry
Infant
Proton Pump Inhibitors
Hydrogen-Ion Concentration
Cytochrome P-450 CYP2C19
Pharmacodynamics
Child, Preschool
Pediatrics, Perinatology and Child Health
Gastroesophageal Reflux
Gastric acid
Female
medicine.symptom
business
medicine.drug
Subjects
Details
- ISSN :
- 1442200X
- Volume :
- 61
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Pediatrics international : official journal of the Japan Pediatric Society
- Accession number :
- edsair.doi.dedup.....c601772e5a7d1795ed4925ada8c97ad8