Nexium Trials

From WikidChem

Nexium tries to boost its sales by heavy advertising.

Note: In the summary by the drug company, Nexium is described as "esomeprazole"; is this a corruption of S-omeprazole?

In a study conducted by the company, Nexium 40mg, and Nexium (resolved active isomer) 20mg were compared with omeprazole (the racemate) 20mg. The healing rates at 4 and 8 weeks showed that Nexium was better. (Note: in some cases, however, the differences were not significant within established confidence intervals; the differences only become truly clear when 40mg of Nexium are used). However, the Nexium 40mg had 4 times, and Nexium 20mg twice the active dose of omeprazole 20mg. The data was intentionally skewed. The reason the company gave for using 20mg omeprazole was that this was the recommended dosage.

Note that the active compound is the (S) omeprazole. While Nexium is 100% (S) omeprazole, the omeprazole used in the study is only 50% (S) omeprazole, 50% (R) omeprazole.

Note: The company claims Nexium will work better because it is broken down more slowly than the mixture omeprazole, as slower-acting "sip" enzymes metabolize it preferentially. The unmetabolized Nexium is responsible for treating acid reflux by binding specifically and irreversibly to proton pumps.