Clinical evaluation of rabeprazole in patients with Zollinger-Ellison syndrome

Rabeprazole, a new-generation of rapid-acting proton pump inhibitor (PPI), was assessed for efficacy and safety in an open-label study, as a treatment of peptic ulcer in patients with Zollinger-Ellison syndrome (ZES). Ten patients (7 males and 3 females; 29-67 years of age) were enrolled. The ZES criteria employed in this study were: high serum gastrin level, elevated basal gastric acid output (BAO), secretin test positive, and histological evidence of gastrinoma. Patients were administered 10 or 20 mg of rabeprazole daily for 232-1,225 days. Significant overall improvement was obtained in 80% of patients who were given rabeprazole for up to 52 weeks and in 87.5% for 52 weeks or more. Out of the ten patients enrolled, eight had endoscopically-confirmed peptic ulcers before the treatment, and complete healing was achieved in five out of the eight patients. In the other two patients, healing could not be confirmed because endoscopic examination was not conducted. Most subjective symptoms disappeared after the initiation of rabeprazole treatment. Although serious adverse events, which were not related to rabeprazole, were reported, no other drug-related adverse reaction was developed. In conclusion, rabeprazole is well tolerated and effective for long-term management of peptic ulcer disease in ZES patients.