PREVENTION OF HEARTBURN RELAPSE BY LOW-DOSE FAMOTIDINE - A TEST MEAL MODEL FOR DURATION OF SYMPTOM CONTROL

Aim: To establish whether patients taking famotidine 10 mg to treat an episode of heartburn were protected from a recurrence of symptoms aft er a subsequent test meal, Methods: Frequent heartburn sufferers (n = 366) were randomized to receive double blind treatment with famotidine 10 mg or 2 x 250 mg chewable alginate tablets within 30 min of a spon taneous episode of heartburn. After 4 h, patients with no or slight re sidual symptoms consumed a meal likely to induce heartburn. Over the n ext 4 h patients recorded the severity of heartburn and any consumptio n of 'rescue' antacids, At the end of this time they rated the global efficacy of their treatment in controlling meal-induced symptoms. Resu lts: Study groups were well matched for all baseline characteristics. Of the 366 randomized patients, 276 took study medication and data fro m 269 patients (132 famotidine, 137 alginate) were analysed for effica cy. Compared to the alginate control group famotidine treated patients reported better global efficacy following the test meal (P < 0.001; r elative odds for a more favourable response: 2.26 [95% CI: 1.45-3.53]) . Fewer patients receiving famotidine resorted to antacid rescue (P = 0.038; relative odds for a more favourable response: 2.24 [95% CI: 1.0 4-4.79]) and peak heartburn was significantly less severe with famotid ine treatment (P < 0.001; relative odds for a more favourable response : 2.90 [9.5% CI: 1.85-4.53]), Eleven famotidine-treated patients (8%) and 13 alginate patients (9%) reported adverse events. Conclusion: Com pared to patients receiving an alginate preparation, patients self med icating with famotidine 10 mg for heartburn are better protected again st a recurrence of their symptoms when they next eat. This suggests th at the duration of acid control (9 h) previously demonstrated with thi s dose translates into a similar duration of measurable symptom contro l during the day.