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A comparison of five maintenance therapies for reflux esophagitis

New England Journal of Medicine, ISSN: 1533-4406, Vol: 333, Issue: 17, Page: 1106-1110
1995
  • 554
    Citations
  • 0
    Usage
  • 48
    Captures
  • 0
    Mentions
  • 0
    Social Media
Metric Options:   Counts1 Year3 Year

Metrics Details

  • Citations
    554
    • Citation Indexes
      543
    • Clinical Citations
      9
      • PubMed Guidelines
        9
    • Policy Citations
      2
      • Policy Citation
        2
  • Captures
    48

Article Description

Patients with reflux esophagitis have a high rate of relapse within one year after therapy is discontinued. We enrolled 175 adults with endoscopy-confirmed reflux esophagitis in a prospective study comparing five maintenance therapies. All the patients were initially treated with omeprazole (40 mg orally once a day) for four to eight weeks, and healing was confirmed by endoscopy. Participants were then stratified according to their initial grade of esophagitis and randomly assigned to 12 months of treatment with one of the following: cisapride (10 mg three times a day), ranitidine (150 mg three times a day), omeprazole (20 mg per day), ranitidine plus cisapride, or omeprazole plus cisapride. Endoscopy was repeated after 6 and 12 months of treatment; the endoscopists were blinded to the treatment assignments. Remission was defined as the absence of esophageal lesions on scheduled or unscheduled follow-up endoscopy. In an intention-to-treat analysis, the numbers of patients in continued remission at 12 months were 19 of 35 (54 percent) in the cisapride group, 17 of 35 (49 percent) in the ranitidine group, 28 of 35 (80 percent) in the omeprazole group, 23 of 35 (66 percent) in the ranitidine-plus-cisapride group, and 31 of 35 (89 percent) in the omeprazole-plus-cisapride group. Omeprazole was significantly more effective than cisapride (P = 0.02) or ranitidine (P =0.003), and combination therapy with omeprazole plus cisapride was significantly more effective than cisapride alone (P = 0.003), ranitidine alone (P<0.001), or ranitidine plus cisapride (P = 0.03). Ranitidine plus cisapride was significantly better than ranitidine alone (P = 0.05). For maintenance treatment of reflux esophagitis, omeprazole alone or in combination with cisapride is more effective than ranitidine alone or cisapride alone, and the combination of omeprazole and cisapride is more effective than ranitidine plus cisapride. © 1995, Massachusetts Medical Society. All rights reserved.

Bibliographic Details

Sergio Vigneri; Rosanna Termini; Gioacchino Leandro; Salvatore Badalamenti; Maurizio Pantalena; Vincenzo Savarino; Francesco di Mario; Giuseppe Battaglia; Giuseppe Sandro Mela; Alberto Pilotto; Mario Plebani; Giovanni Davi

New England Journal of Medicine (NEJM/MMS)

Medicine

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