OMEPRAZOLE IS MORE EFFECTIVE THAN CIMETIDINE IN THE PREVENTION OF RECURRENCE OF GERD-ASSOCIATED HEARTBURN AND THE OCCURRENCE OF UNDERLYING ESOPHAGITIS

Background: There is documentation of the long-term use of omeprazole 10 mg o.d. in patients with reflux oesophagitis but not in the large n umber of gastrooesophageal reflux disease (GERD) patients without oeso phagitis. There is also a paucity of data on the longterm use of cimet idine in GERD patients. Methods: One hundred and fifty-six patients (1 00 male) who previously had symptomatic non-ulcerative oesophagitis (8 1%) or symptoms without oesophagitis (19%), were recruited. All patien ts were in symptomatic remission following 4 weeks of omeprazole 20 mg o.d. or cimetidine 400 mg q.d.s. and, if required, a further 4 weeks of omeprazole 20 mg o.d. Patients were randomized to receive, double-b lind, either omeprazole 10 mg o.m. (n = 77) or cimetidine 800 mg nocte (n = 79) for 24 weeks. Results: A greater proportion of patients rece iving omeprazole, compared with cimetidine, were in symptomatic remiss ion after 12 (69 vs, 27%) and 24 weeks (60 vs, 24%) (each P < 0.0001). The median time to symptomatic relapse was longer for patients receiv ing omeprazole (169 vs. 15 days) (P = 0.0001), Of patients leaving the study in symptomatic remission, a greater proportion receiving omepra zole, compared with cimetidine, was free of oesophagitis (84 vs. 53%) (P < 0.05). Conclusion: Omeprazole 10 mg o.m. is more effective than c imetidine 800 mg nocte in the prevention of recurrence of GERD-associa ted heartburn and the occurrence of underlying oesophagitis.