The effect of once daily omeprazole and succinic acid (VECAM) vs once daily omeprazole on 24-h intragastric pH

Background Parietal cell H+/K+ATPase activation is essential for optimal proton pump inhibitor (PPI) activity. Succinic acid (SA) was shown to induce gastric acid secretion. VECAM is a combination of omeprazole (OMP) and SA. To compare the effect of once daily bedtime dosing of VECAM 40 and VECAM 20 without food vs OMP 20 mg administered before breakfast on gastric acidity. Methods Open label, randomized, crossover study enrolling 36 healthy subjects comparing the study treatments at steady state for 24 h intragastric pH monitoring. Key Results The median percent time intragastric pH > 4 demonstrated that VECAM 40 was superior to VECAM 20 (65.7% vs 49.1% P < 0.0001) and OMP 20 mg (65.7% vs 47.6% P = 0.005) during 24 h. VECAM 40 was superior to VECAM 20 (52.8% vs 38.8% P = 0.0079) and OMP 20 mg (52.8% vs 27.2% P < 0.0001), and VECAM 20 was superior to OMP 20 mg (38.8 vs 27.2 P = 0.0069) during the nighttime. VECAM 20 and OMP 20 mg were comparable during 24 h. Conclusions & Inferences VECAM 40 and VECAM 20 were significantly better in maintaining intragastric pH > 4 during the nighttime than OMP 20 mg. Succinic acid eliminates the need for a subsequent meal for intragastric pH control by VECAM.