Omeprazole is more effective than cimetidine in the prevention of recurrence of GERD‐associated heartburn and the occurrence of underlying oesophagitis

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Abstract
Background: There is documentation of the long‐term use of omeprazole 10 mg o.d. in patients with reflux oesophagitis but not in the large number of gastro‐oesophageal reflux disease (GERD) patients without oesophagitis. There is also a paucity of data on the long‐term use of cimetidine in GERD patients.Methods: One hundred and fifty‐six patients (100 male) who previously had symptomatic non‐ulcerative oesophagitis (81%) or symptoms without oesophagitis (19%), were recruited. All patients were in symptomatic remission following 4 weeks of omeprazole 20 mg o.d. or cimetidine 400 mg q.d.s. and, if required, a further 4 weeks of omeprazole 20 mg o.d. Patients were randomized to receive, double‐blind, either omeprazole 10 mg o.m. (n = 77) or cimetidine 800 mg nocte (n = 79) for 24 weeks.Results: A greater proportion of patients receiving omeprazole, compared with cimetidine, were in symptomatic remission after 12 (69 vs. 27%) and 24 weeks (60 vs. 24%) (each P < 0.0001). The median time to symptomatic relapse was longer for patients receiving omeprazole (169 vs. 15 days) (P = 0.0001). Of patients leaving the study in symptomatic remission, a greater proportion receiving omeprazole, compared with cimetidine, was free of oesophagitis (84 vs. 53%) (P < 0.05).Conclusion: Omeprazole 10 mg o.m. is more effective than cimetidine 800 mg nocte in the prevention of recurrence of GERD‐associated heartburn and the occurrence of underlying oesophagitis.