Prevention of relapse of reflux oesophagitis after endoscopic healing: the efficacy and safety of omeprazole compared with ranitidine.

The prognosis for the acute healing of patients with persistent, erosive or ulcerative reflux oesophagitis depends upon the choice of drug treatment as well as the severity of the initial oesophagitis. The results of this study show that omeprazole, 40 mg once daily (n = 51), is more effective than ranitidine, 300 mg b.i.d. (n = 47), in the acute healing of reflux oesophagitis (90 and 47% healing, respectively; p less than 0.0001). Omeprazole, 20 mg o.m., is also far more effective than ranitidine, 150 mg b.i.d., in the maintenance treatment of these patients; 67% of the omeprazole-treated patients remained in clinical and endoscopic remission throughout the 12-month study period compared with only 10% of those given ranitidine (p less than 0.0001). This therapeutic advantage was achieved without adverse events and without significant abnormalities in the endocrine or exocrine cell population of the oxyntic mucosa. Basal serum gastrin levels were modestly raised after 4 weeks of omeprazole treatment (the change being from 8.6 to 16.9 pmol/l; p less than 0.05), and remained at this level throughout the study period.