Lansoprazole compared with ranitidine for the treatment of nonerosive gastroesophageal reflux disease

Background: Traditionally, proton pump inhibitors are used primarily for pa tients with esophagitis. However, patients with nonerosive reflux disease m ay also benefit from these powerful medications. Objective: To compare the safety and symptom relief efficacy of lansoprazol e with ranitidine therapy and with placebo. Methods: In 2 randomized, double-blind, multicenter trials of 901 patients with symptomatic reflux disease, which was confirmed by endoscopy to be non erosive, received lansoprazole, 15 or 30 mg once daily, ranitidine, 150 mg twice daily; or placebo for 8 weeks. Results: Analysis of daily diary data during the first 4 weeks and for the entire 8 weeks of treatment revealed that patients who were treated with ei ther dosage of lansoprazole reported significantly (P<.05) lower percentage s of days and nights with heartburn, less pain severity of both day and nig ht heartburn, fewer days of antacid use, and smaller amounts of antacid use compared with patients who were treated with ranitidine or placebo. The in cidence of possible or probable treatment-related adverse reactions was com parable among the treatment groups; abdominal pain and diarrhea were the mo st commonly reported adverse events. No statistically significant differenc es were noted between treatment groups in laboratory analyses. Conclusion: Lansoprazole therapy is more effective than standard dosages of ranitidine or placebo in relieving symptoms in patients with endoscopicall y confirmed nonerosive reflux esophagitis.