Randomized comparative study of omeprazole and famotidine in reflux esophagitis.
BACKGROUND
Although proton pump inhibitors (PPI) and H2-receptor antagonists (H2-RA) are routinely used in the treatment of reflux esophagitis (RE), no consensus has been reached yet as to whether the first-choice drug should be PPI or H2-RA. In this study, the effects of omeprazole (OMP) and famotidine (FAM) on RE have been examined in a randomized comparative study.


METHODS
Protocols of OMP 20 mg once daily or FAM 20 mg twice daily for 8 weeks were allocated to 56 cases with RE at random, using an envelope randomization method. Their efficacy in achieving healing was examined endoscopically and a relief from subjective symptoms was compared.


RESULTS
Patient's background such as sex, age, recurrence, hiatal hernia, smoking and drinking habits, and complications, and the severity of esophagitis at the time of enrolment were not significantly different between the two groups. Healing in the OMP group and the FAM group was observed in 72 and 32% (P = 0.025) of patients at week 4 and 95 and 53% (P = 0.003) of patients at week 8, respectively. Subjective symptoms were relieved more frequently in the OMP group (at week 2, 67% compared with 29%, P = 0.005; at week 4, 95% compared with 55%, P = 0.009), but this superiority was not significant at week 8 (94% compared with 65%, P = 0.085). No serious adverse events occurred.


CONCLUSIONS
Omeprazole provided quicker healing and a greater relief from subjective symptoms than did FAM in the treatment of RE, and was considered more suitable as a first-choice drug.
Kawano
Sunao
S
Department of Clinical Laboratory Science, School of Allied Health Sciences, Faculty of Medicine, Osaka University, Japan. kawano@sahs.med.osaka-u.ac.jp
Murata
Hiroaki
H
Tsuji
Shingo
S
Kubo
Mitsuhiko
M
Tatsuta
Masaharu
M
Iishi
Hiroyasu
H
Kanda
Tsutomu
T
Sato
Tomonobu
T
Yoshihara
Harumasa
H
Masuda
Eiji
E
Noguchi
Masahiko
M
Kashio
Shinji
S
Ikeda
Masahiro
M
Kaneko
Akira
A
D000368:Aged; D004341:Drug Evaluation; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D004942:Esophagitis, Peptic / Q000188:drug therapy*; D004945:Esophagoscopy; D015738:Famotidine / Q000627:therapeutic use*; D005260:Female; D005764:Gastroesophageal Reflux / Q000188:drug therapy*; D006635:Histamine H2 Antagonists / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000627:therapeutic use*; D011446:Prospective Studies; D011897:Random Allocation; D016896:Treatment Outcome
D004791:Enzyme Inhibitors; D006635:Histamine H2 Antagonists; D015738:Famotidine; D009853:Omeprazole