Effective maintenance treatment of reflux esophagitis with low-dose lansoprazole. A randomized, double-blind, placebo-controlled trial

Ann Intern Med. 1996 May 15;124(10):859-67. doi: 10.7326/0003-4819-124-10-199605150-00001.

Abstract

Objective: To compare the efficacy of two doses of lansoprazole with that of placebo in preventing recurrence of erosive esophagitis in a 12-month period.

Design: Randomized, double-blind, parallel, placebo-controlled trial.

Setting: 25 U.S. medical centers.

Patients: 173 patients with documented healing of erosive esophagitis after 8 weeks of acid-suppressing therapy.

Intervention: Lansoprazole, 15 mg or 30 mg, or placebo once daily for as long as 12 months.

Measurements: Endoscopy and symptom evaluation after 1, 2, 3, 6, 9, and 12 months of treatment. Endoscopy was also done whenever symptoms suggested erosive changes.

Results: Lansoprazole was significantly superior to placebo in maintaining healing and preventing recurrence of symptoms. By month 1, 45% of placebo recipients remained healed compared with more than 90% of patients in either lansoprazole group. By month 12, only 24% of placebo recipients remained healed compared with 79% of patients receiving 15 mg of lansoprazole and 90% of patients receiving 30 mg of lansoprazole. During the same period, 35% of placebo recipients remained asymptomatic compared with 72% of recipients of 15 mg of lansoprazole and 67% of recipients of 30 mg of lansoprazole. The 15-mg and 30-mg lansoprazole doses did not differ significantly in maintaining healing and controlling symptoms. Follow-up after recurrence of erosion indicated that during the 12 months, 35% of placebo recipients and 2% of lansoprazole recipients had three or more recurrences.

Conclusion: Lansoprazole effectively maintains healing of erosive esophagitis. The 15-mg and 30-mg lansoprazole doses did not differ significantly for use as maintenance treatment.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • 2-Pyridinylmethylsulfinylbenzimidazoles
  • Adult
  • Aged
  • Aged, 80 and over
  • Double-Blind Method
  • Esophagitis, Peptic / drug therapy*
  • Esophagitis, Peptic / pathology
  • Esophagitis, Peptic / prevention & control
  • Esophagoscopy
  • Female
  • Follow-Up Studies
  • Gastric Acid / metabolism
  • Humans
  • Lansoprazole
  • Male
  • Middle Aged
  • Omeprazole / administration & dosage
  • Omeprazole / adverse effects
  • Omeprazole / analogs & derivatives*
  • Placebos
  • Proton Pump Inhibitors*
  • Recurrence
  • Secretory Rate / drug effects

Substances

  • 2-Pyridinylmethylsulfinylbenzimidazoles
  • Placebos
  • Proton Pump Inhibitors
  • Lansoprazole
  • Omeprazole