Pantoprazole 20 mg on demand is effective in the long-term management of patients with mild gastro-oesophageal reflux disease.

A total of 536 patients with endoscopically confirmed GORD grade 0/I were included in this multicentre study. In the acute phase, patients were treated with pantoprazole 20 mg o.d. for 4 weeks to obtain symptom relief. Symptom-free patients were included in the subsequent long-term phase, and were randomly treated on demand with either pantoprazole 20 mg or placebo for 6 months (antacids as rescue medication). After the 4 weeks acute phase, 439 symptom-free patients entered the long-term phase. The perceived average daily symptom load remained significantly lower during the 6-month on-demand treatment with pantoprazole 20 mg as compared to placebo. Both the rates for unwillingness to continue and number of additional antacids taken were also significantly lower with pantoprazole 20 mg than with placebo. Hence, on-demand treatment with pantoprazole 20 mg is safe and effective in maintaining control of the symptoms heartburn, acid regurgitation and pain on swallowing symptoms in patients with GORD grade 0/I with superiority to placebo.