(Fewer) heartaches by the number: better treatment for heartburn
Controlled clinical trials have shown that pantoprazole may provide patients with more effective relief from gastro-oesophageal reflux disease (GORD) than more established treatments such as ranitidine, according to a study in the latest edition of the Medical Journal of Australia.
In a multicentre, randomised, double-blind, parallel-group comparison, 307 patients with heartburn, at 76 general practices in north-west Sydney and Newcastle in New South Wales, were given either pantoprazole (20mg once daily) or ranitidine (150 mg twice daily).
Conducted by Professors Nicholas Talley and Peter Katelaris, and General Practitioners Michael Moore and Arn Sprogis, the study measured frequency and severity of heartburn during treatment by means of the Gastrointestinal Symptom Rating Scale and a patient heartburn diary.
GORD is frequent in the Australian community, and a very common reason for general practice visits. It is usually relapsing or chronic, and most patients require long-term medical management.
Data from the United States and the United Kingdom suggest that heartburn and acid regurgitation may occur weekly in up to 20 per cent of the population and monthly in up to 40 per cent. Similarly high rates have been observed in Australia and New Zealand.
Professor Talley said patients would welcome more effective treatment for GORD.
"Our trial has shown that low-dose pantoprazole once daily was superior to standard-dose ranitidine twice daily for the initial and long-term management of patients with symptomatic GORD in primary care," Professor Talley said.
"These results will give heart to heartburn sufferers and help those with reflux to relax."
The study was coordinated by the University of Sydney, out of Nepean and Concord Hospitals, with the active participation of doctors from the Hornsby Ku-ring-gai Ryde Division of General Practice and the Hunter Urban Division of General Practice.
The Medical Journal of Australia is a publication of the Australian Medical Association.
CONTACT: Professor Nicholas Talley - Overseas and uncontactable
University of Sydney, Penrith
Dr Michael Moore (02) 9799 0933 (B/H); (02) 9484 0988 (A/H)
Central Sydney Division of General Practice
Sarah Crichton, Public Affairs, AMA (02) 6270 5472 (B/H); (0419) 440 076 (A/H)