Omeprazole Versus Ranitidine in the Maintenance Therapy of Reflux Oesophagitis

A systematic review 1 including 5 RCTs with a total of 1,154 subjects was abstracted in DARE.

The remission rates confirmed by endoscopy after 6 months of treatment were 82.4% for omeprazole 20 mg (95% CI 78.2 to 86.6%), 71.9% for omeprazole 10 mg (95% CI 65.5 to 78.3%), 47.5% for omeprazole weekend regime (95% CI 35.8 to 49.5%), 52.3% for ranitidine 150 mg twoce daily (95% CI 44.4 to 60.1%), and 10.6% for placebo (95% CI 5.0 to 16.3).

The remission rates after 6 months of treatment were 80.2% for omeprazole 20 mg (95% CI 73.9 to 86.4%) and 39.4% for ranitidine 300 mg daily (95% CI 31.6 to 47.2). The absolute difference in the proportion of patients in remission after 12 months was 40.8 in favour of omeprazole (NNT = 2.5).

The following decision support rules contain links to this evidence summary:

• PPIs for maintenance therapy of reflux oesophagitis http://www.ebmeds.org/ebmeds/ebmeds_home.asp?mode=scripts&submode=view&id=scr00513&country=UK

References

• Carlsson R, Galmiche JP, Dent J, Lundell L, Frison L. Prognostic factors influencing relapse of oesophagitis during maintenance therapy with antisecretory drugs: a meta-analysis of long-term omeprazole trials. Aliment Pharmacol Ther 1997 Jun;11(3):473-82. [PubMed] [DARE]