Effectiveness and Satisfaction With Rabeprazole in Acid Peptic Disorders: Insights From Real World Observational Study, Power 2.0

Introduction: Acid peptic disorders (APDs), including gastroesophageal reflux disease (GERD) and peptic ulcer disease (PUD), are prevalent conditions that significantly impair quality of life. Proton pump inhibitors (PPIs) are a cornerstone of APD management, but variability in their effectiveness necessitates evaluation, especially in the Indian context, due to lack of data. Methods: The POWER 2.0 study is a multicenter, prospective, observational, non-interventional study that enrolled patients with APDs under routine clinical practice, including treatment-naïve and existing PPI users. Data were collected at baseline (day 0) and after 30 days. The primary objective was to document demographics, clinical presentation, and treatment-related outcomes. Secondary objectives evaluated risk factors, severity, comorbidities, PPI usage-patterns, and satisfaction levels. Results: A total of 622 patients, mean age 44.2±11.93 years, predominantly male (70.9%), were enrolled across 75 Indian sites. GERD was the most diagnosed condition (70.1%). Alcohol use (p=0.0404) and sedentary lifestyle (p=0.0056) were significantly associated with APD severity. Rabeprazole was prescribed most often for treatment-naïve (78.3%) and existing PPI users (39.0%). Among 197 existing PPI users, 56.9% required a switch, mainly from pantoprazole (55.4%). Most switched to rabeprazole (88.3%) due to inadequate symptom relief. Only 7 rabeprazole users required a further switch. Symptom regression occurred in >90% of switched patients and 84.5% of treatment-naïve users and high satisfaction rates. Conclusions: Rabeprazole shows effectiveness in symptom relief and clinician preference. The minimal effect of CYP2C19 metabolism on rabeprazole may have contributed to its consistent efficacy across diverse patient populations, including those switching from other PPIs.