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Prevention of erosive oesophagitis relapse with pantoprazole
Author(s) -
Richter J. E.,
Fraga P.,
Mack M.,
Sabesin S. M.,
Bochenek W.
Publication year - 2004
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2004.02121.x
Subject(s) - pantoprazole , medicine , heartburn , ranitidine , gastroenterology , discontinuation , esophagitis , tolerability , reflux , adverse effect , omeprazole , disease
Summary Aim : To compare the safety and efficacy of pantoprazole and ranitidine in maintaining erosive oesophagitis healing. Methods : Gastro‐oesophageal reflux disease patients (349) with endoscopically documented healed erosive oesophagitis (grade 0 or 1) were randomly assigned to receive pantoprazole (10, 20 or 40 mg/q.d.s.) or ranitidine (150 mg/b.d.). Erosive oesophagitis status was assessed endoscopically at months 1, 3, 6 and 12 or when relapse symptoms appeared (relapse = reappearance of erosive oesophagitis grade 2 within 12 months). Symptom‐free days were also assessed. Results : Pantoprazole 20‐ and 40‐mg were significantly more effective than ranitidine in maintaining healing regardless of initial erosive oesophagitis grade. Response was dose‐related. After 12 months 78, 55, 46 and 21% of patients remained healed (40‐, 20‐, 10‐mg pantoprazole and ranitidine). Pantoprazole 40‐mg produced significantly more symptom‐free days (83%) than ranitidine (58%). Heartburn‐free days/nights were significantly higher with pantoprazole 40‐mg (92 and 93%) than ranitidine (73 and 77%). The most frequent reason for discontinuation, unsatisfactory efficacy, occurred most often with ranitidine ( P < 0.001). Conclusion : Once‐daily pantoprazole therapy prevented relapse of healed erosive oesophagitis more effectively than ranitidine and with fewer heartburn days. Response to pantoprazole was dose‐related. Pantoprazole 40‐mg was the most effective regimen and consistent in maintaining erosive oesophagitis healing with a good safety and tolerability profile.