FACTORS PREDICTING RELAPSE DURING MAINTENANCE TREATMENT WITH FAMOTIDINE IN PATIENTS WITH HEALED REFLUX ESOPHAGITIS

Little is known about possible predictive factors influencing the rela pse rate in patients with healed reflux esophagitis during maintenance therapy with histamine(2) (H-2)-receptor antagonists. Therefore, the efficacy of famotidine 20 mg twice daily was evaluated in an open-labe l prospective study in 317 patients who had experienced healing of ero sive reflux esophagitis after treatment with famotidine; 259 patients completed the study and were assessable according to study protocol. T he cumulative endoscopic relapse rates at 4, 8, and 12 months were 20% , 30%, and 36%, respectively, according to the per-protocol analysis. The most predictive determinant of relapse was the duration of acute t reatment required to achieve healing: Relapse occurred significantly l ess often in patients who experienced healing with 6 weeks of acute tr eatment than in those who experienced healing with 12 and 24 weeks of treatment. The second most important determinant was the initial endos copic severity of the disease. Patients with initial grade I esophagit is had significantly fewer relapses. Relapse rate appeared to be unrel ated to initial severity and duration of symptoms, smoking habits, or strength of acute treatment. The results showed that maintenance thera py with famotidine 20 mg twice daily is effective in a large proportio n of patients with healed reflux esophagitis, with few adverse effects reported.