Skip to main content
Log in

Double-blind comparison of cisapride and cimetidine in treatment of reflux esophagitis

  • Original Articles
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

In a double-blind, randomized, comparative trial of the prokinetic drug cisapride and the H2-blocker cimetidine, mucosal healing and changes in symptoms of gastroesophageal reflux were evaluated in patients with erosive reflux esophagitis. The patients were treated with either cisapride, 10 mg four times a day (N=36) or cimetidine, 400 mg four times a day (N=37) for six weeks, or for 12 weeks if mucosal healing was not obtained by week 6. Upon entry, two thirds of the patients in each group had grade I (Savary-Miller) esophagitis, and the remainder grade II or III. At the end of treatment, endoscopy showed mucosal healing in 56% (38–72%; 95% confidence interval) of cisapride and 57% (39–73%; 95% confidence interval) of cimetidine patients. After six weeks, both drugs significantly (P<0.01) decreased the intensity and frequency of heartburn, regurgitation, and the postural syndrome. No significant inter group differences were found regarding endoscopic parameters or the improvement of heartburn and regurgitation. Concomitant antacid use was also comparable. Adverse effects were reported by four cisapride and nine cimetidine patients. These results indicate that the effects of cisapride compare well with those of cimetidine in terms of both esophageal mucosal healing and symptom relief.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Richter JE, Castell DO: Gastroesophageal reflux: Pathogenesis, diagnosis, and therapy. Ann Intern Med 97:93–103, 1982

    PubMed  Google Scholar 

  2. Goy JA, Maynard JH, McNaughton W, O'Shea A: Ranitidine and placebo in the treatment of reflux oesophagitis: A double-blind randomized trial. Med J Aust 2:558–561, 1983

    PubMed  Google Scholar 

  3. Johansson KE, Boeryd B, Johansson K, Tibbling L: Double-blind cross-over study of ranitidine and placebo in gastro-oesophageal reflux disease. Scand J Gastroenterol 21:769–778, 1986

    PubMed  Google Scholar 

  4. Tytgat GNJ, Nio CY: The medical therapy of reflux oesophagitis. Baill Clin Gastroenterol 1:791–807, 1987

    Google Scholar 

  5. Wesdorp IC: Reflux oesophagitis: A review. Postgrad Med J 62(suppl 2):43–55, 1986

    Google Scholar 

  6. Fraitag B, Cloarec D, Galmiche JP: Le cisapride: Pharmacologie, premiers résultats thérapeutiques et perspectives d'avenir. Gastroenterol Clin Biol 13:265–276, 1989

    PubMed  Google Scholar 

  7. Galmiche JP, Brandstätter G, Evreux M, Hentschel E, Kerstan E, Kratochvil P, Reichel W, Schütze K, Soulé JC, Vitaux J: Combined therapy with cisapride and cimetidine in severe reflux oesophagitis: A double-blind controlled trial. Gut 29:675–681, 1988

    PubMed  Google Scholar 

  8. Janisch HD, Hüttemann W, Bouzo MH: Cisapride versus ranitidine in the treatment of reflux oesophagitis. Hepato-Gastroenterol 35:125–127, 1988

    Google Scholar 

  9. Galmiche JP, Guillard JF, Denis P, Boussakr K, Lefrancois R, Colin R: Etude du pH oesophagien en période postprandiale chez le sujet normal et au cours du syndrome de reflux gastro-oesophagien: Intérêt diagnostique d'un score de reflux acide. Gastroenterol Clin Biol 4:531–539, 1980

    PubMed  Google Scholar 

  10. Kaye M: Post-prandial gastro-oesophageal reflux in healthy people. Gut 18:709–712, 1977

    PubMed  Google Scholar 

  11. Savary M, Miller G: L'oesophage: Manuel et atlas d'endoscopie. Solothurn, Switzerland, Gasmann AG, 1977

    Google Scholar 

  12. Kaul B, Petersen H, Erichsen H, Myrvold HE, Grette K, Halvorsen T, Fjosne U: Gastroesophageal reflux disease: Acute and maintenance treatments with cimetidine. Scand J Gastroenterol 21:139–145, 1986

    PubMed  Google Scholar 

  13. Wesdorp IC: Critical evaluation of controlled clinical trials in the treatment of reflux esophagitis.In Controlled Therapeutic Trials in Gastroenterology. G Dobrilla, A Steele (eds). New York, Raven Press, 1986, pp 37–46

    Google Scholar 

  14. Scarpignato C: Antisecretory drugs in the treatment of GERD: Why, which and how?In Safe and Effective Control of Acid Secretion. M Mignon, JP Galmiche (eds). London, John Libbey, 1988, pp 203–224

    Google Scholar 

  15. Druguet M, Lambert R: Oral cimetidine in reflux oesophagitis: A double-blind controlled trial.In Cimetidine, Proceedings of the Second National Symposium, Brussels, October 27, 1979. A Dresse, F Barbier, C Harvengt, GN Tytgat (eds). Amsterdam, Excerpta Medica, 1980, pp 30–44

    Google Scholar 

  16. Koelz HR, Birchler R, Bretholz A, Bron B, Capitaine Y, Delmore G, Fehr HF, Fumagalli I, Gehrig J, Gonvers JJ, Halter F, Hammer B, Kayasseh L, Kobler E, Miller G, Munst G, Pelloni S, Realini S, Schmid P, Voirol M, Blum AL: Healing and relapse of reflux oesophagitis during treatment with ranitidine. Gastroenterology 91:1198–1205, 1986

    PubMed  Google Scholar 

  17. Lepoutre L, Vanderlinden I, Bollen J, Laukens P: Healing of grade II or III oesophagitis through motility stimulation with cisapride:In Progress in the Treatment of Gastrointestinal Motility Disorders: The Role of Cisapride. AG Johnson, G Lux (eds). Amsterdam, Excerpta Medica, 1988, pp 63–65

    Google Scholar 

  18. Guslandi M: Combined therapies for upper gastrointestinal disorders — any advantage? Lancet 1:1383–1385, 1988

    PubMed  Google Scholar 

  19. Smith JL, Opekun AR, Larkai E, Graham DY: Sensitivity of the esophageal mucosa to pH in gastroesophageal reflux disease. Gastroenterology 96:683–689, 1989

    PubMed  Google Scholar 

  20. McGuigan JE: A consideration of the adverse effects of cimetidine. Gastroenterology 80:181–192, 1981

    PubMed  Google Scholar 

  21. McCallum RW, Prakash C, Campoli-Richards DM, Goa KL: Cisapride: A preliminary review of its pharmacodynamic and pharmacokinetic properties, and therapeutic use as a prokinetic agent in gastrointestinal motility disorders. Drugs 36:652–681, 1988

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Galmiche, J.P., Fraitag, B., Filoche, B. et al. Double-blind comparison of cisapride and cimetidine in treatment of reflux esophagitis. Digest Dis Sci 35, 649–655 (1990). https://doi.org/10.1007/BF01540415

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01540415

Key words

Navigation