OMEPRAZOLE OR RANITIDINE IN LONG-TERM TREATMENT OF REFLUX ESOPHAGITIS

Background/Aims: Patients with reflux esophagitis have rapid relapses after treatment withdrawal. This study was designed to investigate the relapse rate of symptomatic esophagitis during maintenance treatment with omeprazole or ranitidine. Methods: Patients with endoscopically v erified acute erosive or ulcerative esophagitis were initially treated with 20-40 mg omeprazole daily for 8-12 weeks. After healing, the pat ients were randomized to maintenance treatment with omeprazole (20 or 10 mg each morning) or ranitidine (150 mg twice daily). Control endosc opy was performed at the end of the healing phase and after 12 months of maintenance treatment or symptomatic relapse. Results: Of 426 initi ally treated patients, 392 were healed and entered the maintenance stu dy. The estimated proportions of patients in remission after 12 months of maintenance treatment with 20 mg omeprazole once daily (n = 131), 10 mg omeprazole once daily (n = 133), and 150 mg ranitidine twice dai ly (n = 128) were 72%, 62%, and 45%, respectively. Both the 10- and 20 -mg doses of omeprazole were significantly better than the dose of ran itidine (P < 0.001. and P < 0.005, respectively). There was no signifi cant difference between the 10- and 20-mg doses of omeprazole (P = 0.0 6). Conclusions: Maintenance treatment with omeprazole (20 or 10 mg on ce daily) is superior to ranitidine (150 mg twice daily) in keeping pa tients with erosive reflux esophagitis in remission over a 12-month pe riod.