Comparison of the effects of omeprazole and famotidine in treatment of upper abdominal symptoms in patients with reflux esophagitis.
OBJECTIVE
The purpose of this study was to compare the efficacy of proton pump inhibitor (PPI) with H(2) receptor antagonist (H(2)RA) in treatment of upper abdominal symptoms.


METHODS
This was a multi-center, open study conducted at 102 hospitals in Japan. Patients with reflux esophagitis received famotidine 10 mg twice daily for 2 weeks, then omeprazole 10 mg once daily for 2 weeks. Thereafter, patients were switched to famotidine 10 mg twice daily for a third 2-weekperiod, provided those with a medical condition agreed to continue the study. Patients evaluated the treatment response to each gastrointestinal symptom using a predefined patient questionnaire and gastrointestinal symptom rating scale (GSRS).


RESULTS
161 patients entered the study, of whom 8 were excluded from all analyses due to lack of participation following entry. Overall symptom improvement rate (n = 130) at week 4, after the 2-week omeprazole treatment, was 75.4% and this was significantly higher than that after the first 2-week famotidine treatment (41.5%) at week 2. In patients (n = 36) who completed 6 weeks of treatment, 2-week omeprazole treatment at week 4 showed a significantly higher overall symptom improvement rate compared with both the first 2-week and third 2-week famotidine treatments.


CONCLUSIONS
Omeprazole was superior to famotidine for treatment of upper abdominal symptoms in patients with reflux esophagitis, which suggested that gastric acid might be a cause not only of reflux symptoms, but also of ulcer symptoms and dysmotility symptoms such as epigastric pain and feeling of fullness in reflux esophagitis.
Kusunoki
Hiroaki
H
Department of General Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192, Japan. kusunoki@med.kawasaki-m.ac.jp
Kusaka
Masayasu
M
Kido
Soichiro
S
Yamauchi
Ryo
R
Fujimura
Yoshinori
Y
Watanabe
Yasuyuki
Y
Kobori
Michio
M
Miwa
Hiroto
H
Tomita
Toshihiko
T
Kin
Yongmin
Y
Hori
Kazutoshi
K
Tano
Nobuo
N
Sugimoto
Kenji
K
Nakamura
Yoshihiro
Y
Fujimoto
Kazuma
K
Oza
Noriko
N
Matsunobu
Aki
A
Ono
Naofumi
N
Fuyuno
Seisuke
S
Kinoshita
Yoshikazu
Y
Adachi
Kyoichi
K
Yuki
Mika
M
Fujisawa
Tomoo
T
Haruma
Ken
K
D000328:Adult; D000368:Aged; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D004942:Esophagitis, Peptic / Q000188:drug therapy*; D015738:Famotidine / Q000627:therapeutic use*; D005260:Female; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000627:therapeutic use*; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D055815:Young Adult
D000897:Anti-Ulcer Agents; D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors; D015738:Famotidine; D009853:Omeprazole