Omeprazole versus high-dose ranitidine in mild gastroesophageal reflux disease: Short- and long-term treatment

OBJECTIVE: Patients with reflux esophagitis suffer from a chronic condition that may cause considerable discomfort because of recurrent symptoms and d iminished quality of life. This study was designed to evaluate acute and lo ngterm treatment comparing standard doses of omeprazole and high-dose ranit idine. METHODS: Patients with endoscopically verified symptomatic esophagitis grad e I or II were initially treated with omeprazole 20 mg daily or ranitidine 300 mg twice daily for 4-8 wk. Patients who were symptom free were randomiz ed to maintenance treatment with omeprazole 10 mg daily or ranitidine 150 m g twice daily. Patients were seen every 3 months or at symptomatic relapse. RESULTS: The percentage of asymptomatic patients after 4 and 8 wk treatment were 61% and 74%, respectively, for omeprazole and 31% and 50%, respective ly, for ranitidine. Of 446 patients treated initially, 277 were asymptomati c, of whom 263 entered the maintenance study. The estimated proportion of p atients in remission after 12 months of maintenance treatment with omeprazo le 10 mg daily (n = 134) and ranitidine 150 mg twice daily (n = 129) were 6 8% and 39%, respectively (p < 0.0001). CONCLUSIONS: Omeprazole 20 mg daily is superior to high dose ranitidine in the symptomatic treatment of reflux esophagitis grade I and II. Furthermore , omeprazole at half the standard dose is more effective than ranitidine in a standard dose in keeping patients in remission for a period of 12 months . (C) 1999 by Am. Cell. of Gastroenterology.