Background. Randomized controlled trials (RCTs) have been conducted comparing the efficacy of rabeprazole 20？mg or omeprazole 20？mg once daily for patients with erosive gastroesophageal reflux disease (GERD). Until now, no study has synthesized all available data examining this issue. Method. Medline, Embase, and the Cochrane central register of controlled trials were searched (through December 2012). Eligible RCTs recruited adults with erosive GERD and reported endoscopic and symptomatic relief rates at the last point of follow-up. The effect of rabeprazole versus omeprazole was reported as relative risk (RR) of relief with a 95% confidence interval (CI). Results. The search identified 605 citations, and six RCTs containing 1,895 patients were eligible. Endoscopic relief rates were not significantly different between rabeprazole 20？mg and omeprazole 20？mg in treatment trials of up to 8 weeks. Heartburn relief rates were significantly different between the two groups for 8-week treatment trials. Adverse events were not significantly different between the two groups for 8-week treatment trials. Conclusion. These data suggest that rabeprazole demonstrates a clinical advantage over omeprazole in symptomatic relief but no significant difference in endoscopic relief of erosive GERD for up to 8 weeks of treatment. Rabeprazole and omeprazole were both tolerated by GERD patients. 1. Introduction Gastroesophageal reflux disease (GERD) is a recurrent chronic disorder characterized by increased reflux of gastric contents into the lower esophagus that affects approximately 20%–30% of the population worldwide, particularly in western countries [1–3]. Severe reflux esophagitis may develop complications such as esophageal stricture or Barrett’s esophagus [4]. Previous clinical studies have shown that proton pump inhibitors (PPIs) are safer and more effective than H2 receptor antagonists at healing esophageal lesions, relieving heartburn symptoms, and preventing symptomatic and endoscopic relapse [5, 6]. Omeprazole and rabeprazole are both potent inhibitors of H+K+-ATPase, which is responsible for the terminal step in gastric acid secretion [7]. Rabeprazole is a second-generation proton pump inhibitor that has 2- to 10-fold greater antisecretory activity in vitro than omeprazole, the prototypical PPI [8–11]. A rapid pharmacodynamic response may translate to faster onset of symptom relief [9]. However, meta-analysis by Caro et al. showed that rabeprazole was of similar efficacy to omeprazole in terms of heartburn control, healing rates, and relapse rates [5]. Other
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