RAPID SYMPTOM RELIEF IN REFLUX ESOPHAGITIS - A COMPARISON OF LANSOPRAZOLE AND OMEPRAZOLE

Background: Lansoprazole, a substituted benzimidazole, is a proton pum p inhibitor which is highly effective in the control of 24-h intragast ric acidity. The aim of this multicentre, randomized, double-blind stu dy was to compare lansoprazole 30 mg once daily and omeprazole 20 mg o nce daily in the symptom relief and healing of patients with reflux oe sophagitis, Methods: Six hundred and four patients with endoscopically proven oesophagitis and a recent history of heartburn were randomly a ssigned to receive lansoprazole 30 mg or omeprazole 20 mg daily for 4- 8 weeks, Daily assessment of symptoms was made by the patient using a 100-mm Visual Analogue Scale. Clinical symptoms were evaluated at week s 0, 1, 4 and 8. Endoscopic assessment of healing, defined by normaliz ation of the oesophageal mucosal appearance, was made at weeks 4 and 8 . Results: Two hundred and eighty-two patients in the lansoprazole gro up and 283 patients in the omeprazole group were eligible for inclusio n in the per protocol analysis. At 3 days, there was a significant imp rovement in daytime symptoms of heartburn for patients in the lansopra zole group compared with the omeprazole group (P = 0.05). A similar bu t nonsignificant trend was seen at 7 days (P = 0.18), Clinical assessm ent at 7 days demonstrated significant improvement in daytime epigastr ic pain in the lansoprazole group compared with the omeprazole group ( P = 0.03), with a similar but non-significant trend in night-time epig astric pain (P = 0.07), Healing rates of oesophagitis at 4 and 8 weeks were 70 and 87%, respectively, with lansoprazole, and 63 and 82%, res pectively, with omeprazole. Logistic regression analysis of the cumula tive healing rates, which included baseline factors affecting outcome, resulted in an odds ratio of 1.46 (95% CI = 0.87-2.45), suggesting a higher chance of being healed with lansoprazole treatment compared wit h omeprazole treatment. A total of 615 adverse events were reported by 308 (51%) patients during the study period. The majority of events we re mild in nature and the incidence was similar in both treatment grou ps, The most frequently reported events were headache, diarrhoea and n ausea, Conclusion: Lansoprazole provides greater symptom relief compar ed with omeprazole during the first week of treatment. Both treatments were effective in healing oesophagitis.