[Long-term maintenance treatment of reflux esophagitis resistant to H2-RA with PPI (lansoprazole)].
97 patients in 49 hospitals with erosive esophagitis unhealed after at least 8 weeks treatment with H2-RA were given primary treatment with 30 mg lansoprazol once daily. After 8 weeks of treatment with lansoprazol, 75(77%) patients were endoscopically healed. Healed patients were then given maintenance treatment with either 30 mg lansoprazol once daily, 15 mg lansoprazol once daily or 20 mg famotidine twice daily for 24 weeks. 86% of patients randomized to 30 mg lansoprazol, 70% of patients randomized to 15 mg lansoprazol were maintained in endoscopic healing throughout 24 weeks as compared with only 12% of patients randomized to famotidine in endoscopic healing. After 24 weeks of lansoprazol treatment basal gastrin levels were moderately increased. However no significant histopathologic lesion was found in the oxyntic gland mucosa. PPI(lansoprazol) was far superior to H2-RA(famotidine) in preventing recurrence of healed erosive esophagitis. A goal achieved without adverse events and significant abnormalities in the oxyntic mucosal exocrine or endocrine cell but a moderate increase in basal gastrine levels.
Endo
M
M
Kudan-zaka Hospital, Surgical Department.
Sugihara
K
K
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D004311:Double-Blind Method; D004351:Drug Resistance; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D004942:Esophagitis, Peptic / Q000188:drug therapy*; D015738:Famotidine / Q000627:therapeutic use; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D064747:Lansoprazole; D008134:Long-Term Care; D009853:Omeprazole / Q000031:analogs & derivatives* / Q000627:therapeutic use; D054328:Proton Pump Inhibitors
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D004791:Enzyme Inhibitors; D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors; D064747:Lansoprazole; D015738:Famotidine; D009853:Omeprazole