Brief Article
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World J Gastroenterol. May 21, 2012; 18(19): 2390-2395
Published online May 21, 2012. doi: 10.3748/wjg.v18.i19.2390
A randomized open-label trial of on-demand rabeprazole vs ranitidine for patients with non-erosive reflux disease
Abdallah A Kobeissy, Jana G Hashash, Faek R Jamali, Assaad M Skoury, Reham Haddad, Sarah El-Samad, Rami Ladki, Rola Aswad, Assaad M Soweid
Abdallah A Kobeissy, Jana G Hashash, Assaad M Skoury, Assaad M Soweid, Division of Gastroenterology, Department of Internal Medicine, American University of Beirut Medical Center, Hamra 1103 2090, Beirut, Lebanon
Faek R Jamali, Department of Surgery, American University of Beirut Medical Center, Hamra 1103 2090, Beirut, Lebanon
Reham Haddad, Sarah El-Samad, Rami Ladki, Rola Aswad, Department of Pharmacy Practice, School of Pharmacy, Lebanese American University, PO Box 36, Byblos, Lebanon
Author contributions: Jamali FR and Soweid AM designed the study; Kobeissy AA, Hashash JG, and Skoury AM analyzed, interpreted the data and drafted the manuscript; Haddad R, El-Samad S, Ladki R and Aswad R gathered the data; Jamali FR and Soweid AM edited and critically revised the manuscript.
Correspondence to: Assaad M Soweid, MD, FASGE, FACG, Associate Professor of Medicine, Division of Gastroenterology, Department of Internal Medicine, American University of Beirut Medical Center, PO Box 113-6044, Hamra 1103 2090, Beirut, Lebanon. as25@aub.edu.lb
Telephone: +961-1-374374 Fax: +961-1-370814
Received: May 20, 2011
Revised: June 22, 2011
Accepted: April 12, 2012
Published online: May 21, 2012
Abstract

AIM: To compare the efficacy of the proton-pump inhibitor, rabeprazole, with that of the H2-receptor antagonist, ranitidine, as on-demand therapy for relieving symptoms associated with non-erosive reflux disease (NERD).

METHODS: This is a single center, prospective, randomized, open-label trial of on-demand therapy with rabeprazole (group A) vs ranitidine (group B) for 4 wk. Eighty-three patients who presented to the American University of Beirut Medical Center with persistent gastroesophageal reflux disease (GERD) symptoms and a normal upper gastrointestinal endoscopy were eligible for the study. Patients in group A (n = 44) were allowed a maximum rabeprazole dose of 20 mg twice daily, while those in group B (n = 39) were allowed a maximum ranitidine dose of 300 mg twice daily. Efficacy was assessed by patient evaluation of global symptom relief, scores of the SF-36 quality of life (QoL) questionnaires, total number of pills used, and number of medication-free days.

RESULTS: Among the 83 patients who were enrolled in the study, 76 patients (40 in the rabeprazole group and 36 in the ranitidine group) completed the 4-wk trial. Baseline characteristics were comparable between both groups. After 4 wk, there was no significant difference in the subjective global symptom relief between the rabeprazole and the ranitidine groups (71.4% vs 65.4%, respectively; P = 0.9). There were no statistically significant differences between mean cumulative scores of the SF-36 QoL questionnaire for the two study groups (rabeprazole 22.40 ± 27.53 vs ranitidine 17.28 ± 37.06; P = 0.582). There was no significant difference in the mean number of pills used (rabeprazole 35.70 ± 29.75 vs ranitidine 32.86 ± 26.98; P = 0.66). There was also no statistically significant difference in the mean number of medication-free days between both groups.

CONCLUSION: Rabeprazole has a comparable efficacy compared to ranitidine when given on-demand for the treatment of NERD. Both medications were associated with improved quality of life.

Keywords: Proton-pump inhibitors, H2-receptor antagonists, Non-erosive reflux disease, Gastroesophageal reflux disease, Quality of life