JOAQUIM PRADO PINTO DE MORAES FILHO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Gastroenterologia, Faculdade de Medicina - Docente
4 resultados
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- Randomised clinical trial: daily pantoprazole magnesium 40 mg vs. esomeprazole 40 mg for gastro-oesophageal reflux disease, assessed by endoscopy and symptoms(2014) MORAES-FILHO, J. P.; PEDROSO, M.; QUIGLEY, E. M. M.BackgroundPantoprazole magnesium (pantoprazole-Mg) may display extended inhibition of the proton pump with the potential for improved clinical efficacy in gastro-oesophageal reflux disease (GERD). AimTo compare the efficacy of pantoprazole-Mg and esomeprazole in GERD. MethodsGastro-oesophageal reflux disease (Los Angeles grades A-D) patients were randomised to 4weeks of treatment with pantoprazole-Mg (n=290) or esomeprazole (n=288), both 40mg once daily, in this multicentre (14 Brazilian sites in 9 cities), double-blind study, with an additional 4weeks' treatment in nonresponding patients. Severity of oesophagitis (at endoscopy) and GERD-related symptoms (ReQuest-GI) were assessed. The primary end point was the proportion of patients in complete remission (ReQuest-GI score <1.73 plus endoscopic healing) at week 4. ResultsComplete remission occurred in 61% of patients in each treatment group at 4weeks (primary endpoint) and in 81% and 79% of patients in the pantoprazole-Mg and esomeprazole groups at 8weeks, with no significant differences. Mucosal healing rates were high and not significantly different. At 8weeks, symptom relief with pantoprazole-Mg was significantly greater than that with esomeprazole (91.6% vs. 86.0%, P=0.0370) because of continued improvement in symptoms with pantoprazole-Mg from week 4 to week 8 (P=0.0206). ConclusionsPantoprazole-Mg 40mg was at least as effective as esomeprazole 40mg for complete remission and the mucosal healing rate was high. Symptom relief with pantoprazole-Mg continued to improve from 4 to 8weeks and was greater than that with esomeprazole at week 8, suggesting an extended period of treatment effect (ClinicalTrials.gov identifier: NCT01132638).
- Potassium-competitive acid blockers, a new therapeutic class, and their role in acid-related diseases: a narrative review(2023) DOMINGUES, Gerson; CHINZON, Decio; MORAES-FILHO, Joaquim Prado P.; SENRA, Juliana Tosta; PERROTTI, Marcos; ZATERKA, SchliomaIntroduction: A new therapeutic class, potassium-competitive acid blockers (P-CABs), has emerged in Brazil to promote a superior antisecretory effect addressing the unmet needs related to acid-related disease management. Vonoprazan fumarate showed a good safety profile and was approved by the Brazilian regulatory agency - ANVISA.Aim: This narrative review was conducted to review the general concepts regarding P-CABs, focussing on vonoprazan fu-marate.Material and methods: A literature search was conducted through April-May 2021 using official databases with a combi-nation of MeSH controlled vocabulary and text words. The authors selected articles that described pivotal and novel insights about P-CABs and vonoprazan fumarate.Results: Vonoprazan is a drug of the P-CABs class newly approved for the management of acid-related diseases in Brazil. P-CABs achieve rapid, potent, and prolonged acid suppression (including night-time) and promise to address some unmet clinical needs in GERD. Furthermore, considering the difficulties encountered in attaining effective symptomatic control - particularly at night - using currently available PPIs, this new drug class is promising.Conclusions: This review brings important information about vonoprazan, a new therapeutic option in Brazil, which may be considered as a valuable tool for managing acid-related diseases.
- Standard Triple Therapy versus Sequential Therapy in Helicobacter pylori Eradication: A Double-Blind, Randomized, and Controlled Trial(2015) EISIG, Jaime Natan; NAVARRO-RODRIGUEZ, Tomas; TEIXEIRA, Ana Cristina Sa; SILVA, Fernando Marcuz; MATTAR, Rejane; CHINZON, Decio; HARO, Christiane; DINIZ, Marcio Augusto; MORAES-FILHO, Joaquim Prado; FASS, Ronnie; BARBUTI, Ricardo CorreaAim. To compare 10-day standard triple therapy versus sequential therapy as first-line treatment in patients infected with H. pylori. Methods. One hundred H. pylori positive patients (diagnosed by rapid urease test and histology), with average age of 47.2, M/F = 28/72, were randomized to receive either standard triple treatment (TT) as follows: lansoprazole 30 mg, clarithromycin 500 mg, and amoxicillin 1 g, b.i.d. for ten days, or sequential treatment (ST) as follows: lansoprazole 30 mg, amoxicillin and placebo 1.0 g b.i.d for the first five days, followed by lansoprazole 30 mg, clarithromycin 500 mg, and tinidazole 500 mg b.i.d, for the remaining five days. Eradication rates were determined 60 days after treatment by urease, histology, or C-13-urea breath test. Results. In intention to treat (ITT) analysis, the rate of H. pylori eradication in the TT and ST groups was the same for both regimens as follows: 86% (43/50), 95% CI 93,3 to 73.4%. In Per protocol (PP) analysis, the rate of H. pylori eradication in the TT and ST groups was 87.8% (43/49), 95% CI 94,5 to 75.3% and 89.6% (43/48), 95% CI 95,8 to 77.3%, respectively. Conclusions. In Brazil, standard triple therapy is as equally effective as sequential therapy in eradicating Helicobacter pylori patients. This study was registered under Clinical Trials with number ISRCTN62400496.
- Vonoprazan in the management of erosive oesophagitis and peptic ulcer-induced medication: a systematic review(2022) CHINZON, Decio; MORAES-FILHO, Joaquim Prado P.; DOMINGUES, Gerson; GUEDES, Juliana Leite Soares; SANTOS, Claudia Yang; ZATERKA, SchliomaIntroduction: Vonoprazan has been found to promote a better antisecretory effect addressing acid-related diseases' unmet needs. Aim: To assess if vonoprazan effectively treats patients diagnosed with gastroesophageal reflux disease esophagitis or with peptic ulcers induced by chronic use of aspirin or non-steroidal anti-inflammatory drugs. Material and methods: A literature search was conducted (April/2021) using Medline via PubMed, Cochrane library, Lilacs, Scielo, and Centre for Reviews and Dissemination electronic databases. Results: We retrieved 55 titles. Of these, 13 met the eligibility criteria and were included in this review. Of these 13 articles, 4 were prospective cohort studies, 1 was a follow-up analysis of a preceding prospective study, 1 was a retrospective cohort study, and 6 were randomized clinical trials. Conclusions: Our findings suggest that vonoprazan was effective and non-inferior to proton pump inhibitors in healing and maintaining healed reflux oesophagitis, leading to faster symptom relief. Vonoprazan may also be considered for preventing aspirin-or non-steroidal anti-inflammatory drug-related peptic ulcer recurrence.