COMPARISON OF OMEPRAZOLE AND FAMOTIDINE ON ESOPHAGEAL PH IN PATIENTS WITH MODERATE TO SEVERE ESOPHAGITIS - A CROSS-OVER STUDY

Objectives: This open cross-over study compared the effects on esophag eal pH of omeprazole (O) (20 mg once a day) and famotidine (F) (40 mg b.i.d.) in 19 patients with proven acid gastroesophageal reflux (GER) complicated by erosive or ulcerated esophagitis. Methods: Each drug wa s taken for 7 days. A wash-out interval of at least 3 days separated t he two treatment periods in each subject. Twenty-four-hour pH measurem ents were performed in similar standardized conditions at 7 +/- 2 days , at the end of each period of treatment. Results: Compared with the p retreatment results, both O and F reduced the following pH parameters: percent of time with esophageal pH < 4, total number of GER episodes, number of nocturnal GER episodes, and duration of the longest GER epi sodes. O was more effective than F except for the percent of time esop hageal pH < 4 and the number of nocturnal GER episodes, not different between the two treatments. With O, GER was reduced to physiological v alue in 19 of the 19 patients and abolished in 13. With F, GER was nor malized in 13 and abolished in four. The effects of both drugs and gra ding of esophagitis were not correlated. Both treatments were well-tol erated. Conclusions: In patients with acid GER complicated by ulcerati ve esophagitis, O, 20 mg daily, and F, 40 mg b.i.d. significantly redu ced acid exposure. O was superior to F, but the latter drug improved s ignificantly two important prognostic variables: the total percent of time pH < 4 and the nocturnal GER.