Pantoprazole maintenance therapy prevents relapse of erosive oesophagitis.
OBJECTIVE
To compare the safety and efficacy of pantoprazole with ranitidine for the maintenance of endoscopically documented healed (grade 0 or 1) erosive oesophagitis.


METHODS
Patients (371) were randomly assigned to receive pantoprazole 10, 20 or 40 mg or ranitidine 150 mg. Endoscopies were performed after 1, 3, 6 and 12 months or when symptoms suggesting relapse (grade = 2) developed. Gastric biopsies were obtained at baseline and on at least one postbaseline visit. Symptom-free days and Gelusil use were assessed.


RESULTS
Pantoprazole was significantly (P < 0.001) more effective in maintaining erosive oesophagitis healing. After 12 months, 33%, 40%, 68% and 82% of patients remained healed for the ranitidine and pantoprazole 10, 20 and 40 mg groups, respectively. Daytime and night-time heartburn were eliminated in > 90% of days for the pantoprazole 40 mg group. Gelusil use was significantly lower with pantoprazole 20 and 40 mg than with ranitidine (P < 0.02) during the first 9 months.


CONCLUSIONS
Twelve months of maintenance therapy with pantoprazole (10-40 mg once daily) was superior to ranitidine (150 mg twice daily) in maintaining erosive oesophagitis healing. Pantoprazole 40 mg provided the most consistent efficacy and was well tolerated.
Metz
D C
DC
Division of Gastroenterology, University of Pennsylvania Health System, 3400 Spruce Street, 3 Dulles, Philadelphia, PA 19104-4283, USA. david.metz@uphs.upenn.edu
Bochenek
W J
WJ
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000328:Adult; D000368:Aged; D000536:Aluminum Hydroxide / Q000008:administration & dosage; D000897:Anti-Ulcer Agents / Q000008:administration & dosage*; D001562:Benzimidazoles / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D004338:Drug Combinations; D004941:Esophagitis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008276:Magnesium Hydroxide / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000031:analogs & derivatives; D000077402:Pantoprazole; D011899:Ranitidine / Q000008:administration & dosage*; D012008:Recurrence; D012824:Silicic Acid / Q000008:administration & dosage; D013454:Sulfoxides / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D001562:Benzimidazoles; D004338:Drug Combinations; D013454:Sulfoxides; D012824:Silicic Acid; D000536:Aluminum Hydroxide; C036656:Gelusil; D011899:Ranitidine; D000077402:Pantoprazole; D009853:Omeprazole; D008276:Magnesium Hydroxide