Randomised controlled trial of pantoprazole versus ranitidine for the treatment of uninvestigated heartburn in primary care.

Author(s): Talley NJ, Moore MG, Sprogis A, Katelaris P

Affiliation(s): University of Sydney, Nepean Hospital, PO Box 63, Penrith, NSW 2751, Australia. ntalley@med.usyd.edu.au

Publication date & source: 2002-10-21, Med J Aust., 177(8):423-7.

Publication type: Clinical Trial; Multicenter Study; Randomized Controlled Trial

OBJECTIVES: To investigate whether pantoprazole (20 mg/d) produces significantly greater symptom control than ranitidine (300 mg/d) in patients with gastro-oesophageal reflux disease (GORD). DESIGN: Multicentre, randomised, double-blind, parallel-group comparison. SETTING: 76 general practices in north-west Sydney and Newcastle, New South Wales (Australia), from 19 January 1999 to 22 September 2000. PATIENTS: 307 patients aged 18 years or over presenting with symptomatic GORD. INTERVENTIONS: Pantoprazole (20 mg once daily) or ranitidine (150 mg twice daily). MAIN OUTCOME MEASURES: Patient-assessed frequency and severity of heartburn using the Gastrointestinal Symptom Rating Scale (GSRS) and a patient heartburn diary. RESULTS: Pantoprazole was associated with significantly higher rates of complete control of GORD symptoms than ranitidine at four weeks (40% v 19%; P < 0.001), eight weeks (55% v 33%; P < 0.001), six months (71% v 56%; P = 0.007) and 12 months (77% v 59%; P = 0.001). CONCLUSIONS: Low-dose pantoprazole is an effective alternative to standard-dose ranitidine for initial and maintenance treatment of patients with symptomatic GORD.