Skip to main content
SpringerLink
Log in

Prévention des récidives de l’oesophagite par reflux par le lansoprazole: 30 mg un jour sur deux ou 15 mg tous les jours?

Prevention of relapse of gastro-oesophageal reflux disease by lansoprazole: 30 mg every other day or 15 mg daily?

  • Published:
Acta Endoscopica

Résumé

Le but de cette étude était de comparer l’efficacité et la tolérance de deux schémas thérapeutiques: lansoprazole 30 mg un jour sur deux ou lansoprazole 15 mg tous les jours, dans la prévention des récidives de l’oesophagite par reflux. 52 patients ayant présenté une oesophagite par reflux de grade supérieur ou égal à II, cicatrisée après 4 ou 8 semaines de traitement par inhibiteur de la pompe à protons (lansoprazole 30 mg, oméprazole 20 mg ou pantoprazole 40 mg) ont été inclus dans cet essai multicentrique, contrôlé, réalisé en double a liste de randomisation pré-établie, les patients ont reçu pendant 6 mois soit du lansoprazole 30 mg les jours pairs et du placebo les jours impairs (groupe L30), soit du lansoprazole 15 mg tous les jours (groupe L15). Les symptômes du reflux, gastro-oesophagien étaient recherchés après 3 et 6 mois de traitement. Une endoscopie était réalisée en fin d’étude ou en cours d’essai en cas de récidive de la symptomatologie

Le taux de rémission endoscopique à 6 mois était de 64% dans le groupe L30 et de 74,1% dans le groupe L15 (NS). Une aggravation du pyrosis et de la gêne fonctionnelle était constatée dans le groupe L30 (p<0,05), alors que la symptomatologie des patients restait stable dans le groupe L15.

Cette étude n’a pas mis en évidence de différence en terme d’efficacité entre les deux schémas thérapeutiques dans la prévention des récidives endoscopiques de l’œsophagite par reflux. Cependant, les meilleurs résultats obtenus avec le lansoprazole 15 mg sur la symptomatologie suggèrent une possible supériorité du traitement quotidien à demi-dose par rapport au traitement à pleine dose un jour sur deux.

Summary

The aim of this study was to compare efficacy and safety of two therapeutic regimens: lansoprazole 30 mg every other day or lansoprazole 15 mg once daily in the prevention of gastro-oesophageal reflux disease relapses. 52 patients with an oesophagitis of severity greater than or equal to grade II, healed after 4 to 8 weeks of treatment with a proton pump inhibitor (lansoprazole 30 mg/day, omeprazole 20 mg/day or pantoprazole 40 mg/day) were included in this multicentre, double blind study. According to randomisation, patients received either lansoprazole 30 mg on even days and a placebo on odd days (group L30) or lansoprazole 15 mg daily (group L15) for 6 months. After 3 and 6 months of treatment, symptoms of gastro-oesophageal reflux were reported. Endoscopy was performed at the end of the study or in case of symptomatic relapse.

The endoscopic remission rates after 6 months, were 64% and 74.1% for group L30 and L15 respectively (NS). An aggravation of heartburn and functional handicap was noted in group L30 (p<0.05), whereas symptomatology of group L15 patients remained stable.

No difference in efficacy between the two therapeutic regimens for the prevention of endoscopic relapses of gastro-oesophageal reflux disease was shown in this study. Nevertheless, the better symptomatic results obtained with lansoprazole 15 mg daily suggest that daily half-dose treatment is possibly better than full-dose treatment every other day.

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

Access this article

Log in via an institution

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

Instant access to the full article PDF.

Institutional subscriptions

Références

  1. RICKLER J.E. — A critical review of current medical therapy for gastroesophageal reflux disease.J. Clin. Gastroenterol., 1986,8(1), 72–80.

    Article  Google Scholar 

  2. BARDHAN K.D., HAWKEY K.G., LONG R.G.et al. — Lansoprazole versus ranitidine for the treatment of reflux oesophagitis.Aliment. Pharmacol. Ther., 1995,9, 145–151.

    PubMed  CAS  Google Scholar 

  3. PETITE J.P., AUCOMTE A., BARBARE J.C., BARTHELEMY C., BOYER J.D., COUGARD A. — Lansoprazole versus ranitidine dans le traitement de l’esophagitis peptique. Etude multicentrique.Med. Chir. Dig., 1991,20, 462–468.

    Google Scholar 

  4. ZEITOUN P.et al. — Oméprazole (20mg/j) comparé à ranitidine (150 mg 2 fois/j) dans le traitement de l’œsophagite par reflux. Résultats d’un essai multicentrique franco-belge randomisé en double insu.Gastroenterol Clin. Biol., 1989,13, 457–462.

    PubMed  CAS  Google Scholar 

  5. HATLEBAKK J.G., BERSTAD A., CARLING L.et al. — Lansoprazole versus omeprazole in short term treatment of reflux esophagitis.Scand. J. Gastroenterol., 1993,28, 224–228.

    Article  PubMed  CAS  Google Scholar 

  6. ROBINSON M., SAHBA B., AVNER D., JHALA N., GRESKI-ROSE P.A., JENNINGS D.E. A comparison of lansoprazole and ranitidine in the treatment of erosive oesophagitis.Aliment. Pharmacol. Ther., 1995,9, 25–31.

    PubMed  CAS  Google Scholar 

  7. KOELZ H.R., BIRCHLER R., BRETZHOLZ A.et al. — Healing and relapse of reflux esophagitis during treatment with ranitidine.Gastroenterology, 1986,91, 1198–1205.

    PubMed  CAS  Google Scholar 

  8. SANDMARK S., CARLSSON R., FAUSSA O.et al. — Omeprazole or ranitidine in the treatment of reflux esophagitis. Results of a double-blind, randomized, Scandinavian multicenter study.Scand J. Gastroenterol., 1988,23, 625–632.

    Article  PubMed  CAS  Google Scholar 

  9. KLINKENBERG-KNOL E.C., JANSEN J.B., LAMERS C.B.et al. — Use of omeprazole in the management of reflux oesophagitis resistant to H2-receptor antagonists.Scand. J. Gastroenterol., 1989,166, 88–93.

    Article  CAS  Google Scholar 

  10. HETZEL D.J.et al. — Healing and relapse of severe peptic esophagitis after treatment with omeprazole.Gastroenterology, 1988,95, 903–912.

    PubMed  CAS  Google Scholar 

  11. KOELZ H.R.et al. — Healing and relapse of reflux esophagitis during treatment with ranitidine.Gastroenterology, 1986,91 1198–1205.

    PubMed  CAS  Google Scholar 

  12. SONTAG S.et al. — Study group: ranitidine versus placebo in long-term treatment of gastroesophageal reflux (GERD).Gastroenterology, 1985,88, 1595.

    Google Scholar 

  13. FIASSE R., DRUEZ P., COPPENS J.P.et al. — Omeprazole in the treatment of patients with severe reflux oesophagitis not responding to H2-receptor antagonists and ineligible for surgery.Acta Gastro-Enterologica Belgica, 199053, 573–584.

    PubMed  CAS  Google Scholar 

  14. LUNDELL L., BACKMAN L., EKSTRÖM P.et al. — Prevention of relapse of reflux esophagitis after endoscopic healing: the efficacy and safety of omeprazole compared with ranitidine.Scand. J. Gastroenterol., 1991,26, 248–256.

    Article  PubMed  CAS  Google Scholar 

  15. VALLOT T., CARELLA G. — Efficacy of proton pump inhibitors in the treatment of gastro-oesophagal reflux disease.Gastroenterol. Clin. Biol., 1999,23, 97S-109S.

    Google Scholar 

  16. SAVARY M., MILLER G. — The esophagus-handbook and atlas of endoscopy. Solothurn, Switzerland: Verlag Gassmann AG: 1978.

    Google Scholar 

  17. DE MEESTER T.R., JOHNSON L.F., JOSEPH G.J., TOSCANO M.S., HALL A.W., SKINNER D.B. — Patterns of gastro-esophageal reflux in health and disease.Ann. Surg. 1976,184, 459–470.

    Google Scholar 

  18. SONTAG S.J., KOGUT D.G., FLEISCHMANN R., CAMPBELL D.R., RICHTER J., HABER M. — Lansoprazole prevents recurrence of erosive reflux esophagitis, previously resistant to H2-RA therapy.Am. J. Gastroenterol., 1996,9, 1758–1765.

    Google Scholar 

  19. ZEITOUN P., CARTERET E., THIEFIN G., RENARD P., LE LOUARGANT M. — Histoire naturelle des oesophagites par reflux.Méd. Hyg., 1989,47, 2641–2643.

    Google Scholar 

  20. HOUCKE P.H., PAPAZIAN A., REY J.F.et al. — Le reflux gastro-oesophagien: recherche de facteurs prédictifs de gravité. Résultats d’une enquête auprès de 248 gastro-entérologues libéraux.Acta Endoscopica, 1998,28, 367–375.

    Article  Google Scholar 

  21. HOUCKE P.H., PAPAZIAN A., AZIERE F., REY, J.F. RAYMOND J.M. — Facteurs prédictifs de gravité du gastrooesophageal reflux (RGO). Résultats d’une enquête chez 2 035 patients avec endoscopie.Gastroenterol. Clin. Biol. 1998,22, A113.

    Google Scholar 

  22. ROBINSON M., LANZA F., AVNER D., HABER M. — Effective maintenance treatment of reflux esophagitis with low-dose lansoprazole.Ann. Intern. Med., 1996,124, 859–867.

    PubMed  CAS  Google Scholar 

  23. BARDHAN K.D., BALDI F., BORMAN B.C., BRULLET E., DENT J., GALMICHE J.P.et al. — Lansoprazole maintains healing in patients with reflux esophagitis.Gastroenterology, 1996,110(4), A56.

    Google Scholar 

  24. HATLEBAKK J.G., BERSTAD A. — Lansoprazole 15 and 30 mg daily in maintaining healing and symptom relief in patients with reflux oesophagitis.Aliment. Pharmacol. Ther., 1997,11, 365–372.

    Article  PubMed  CAS  Google Scholar 

  25. GOUGH A.L., LONG R.G., COOPER B.T., FOSTER C.S., GARRET A.D., LANGWORTHY C.H. — Lansoprazole versus ranitidine in the maintenance treatment of reflux esophagitis.Aliment. Pharmacol. Ther., 1996,10, 529–539.

    Article  PubMed  CAS  Google Scholar 

  26. STANGHELLINI V. — Gastro-oesophageal reflux disease: therapeutic strategies for the new millennium.Eur. J. Clin. Res., 1997,9, 71–77.

    Google Scholar 

  27. DEVAULT K.R., CASTELL D.O. — Guidelines for the diagnosis and treatment of gastroesophageal reflux disease.Arch. Intern. Med., 1995,155, 2165–2173.

    Article  PubMed  CAS  Google Scholar 

  28. DENT J., YOMANS N.D., MACKINNON M.— Omeprazole versus ranitidine for prevention of relapse in reflux oesophagitis: a controlled double blind trial of their efficacy and safety.Gut, 1994,35, 590–598.

    Article  PubMed  CAS  Google Scholar 

  29. ZEITOUN P., BARBIER, P., CAYPHAS J.P., ISAL J.P., CARLSSON R. — Comparison of two dosage regimens of omeprazole-10 mg once daily and 20 mg weekends — as prophylaxis against recurrence of relfux esophagitis.Hepato-gas-troenterol., 1989,36, 279.

    Google Scholar 

  30. STAERKLAURSEN, L., HAVELUND T., BONDESEN S.et al. — Omeprazole in the long-term treatment of gastro-oesophageal reflux disease.Scand. J. Gastroenterol., 1995,30, 839–846.

    Article  Google Scholar 

  31. BATE C.M., BOOTH S.N., CROWE J.P.et al. — Omeprazole 10 mg or 20 mg once daily in the prevention of recurrence of reflux oesophagitis.Gut, 1995,36, 492–498.

    Article  PubMed  CAS  Google Scholar 

  32. BARDHAN K.D., CHERIAN P., VAISHNAVI A.et al. — Erosive oesophagitis: outcome of repeated long term maintenance treatment with low dose omeprazole 10 mg or placebo.Gut, 1998,43, 458–464.

    Article  PubMed  CAS  Google Scholar 

  33. HLLERBACK B., UNGE P., CARLING L.et al. — Omeprazole or Ranitidine in long-term treatment of reflux esophagitis.Gastroenterology, 1994,107, 1305–1311.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. 104, rue de Jennoges, 59800, Lille, France

    Ph. Houcke

  2. Groupe d’étude du CREGG, France

    Ph. Houcke, D. Goldfain, P. Guyot, Th. Helbert, J. Laurent, J. F. Rey, D. Rouhier, J. Cassigneul, B. Marchetti & A. Papazian

  3. Laboratoires Takeda, Puteaux, France

    M. Laurence

Authors
  1. Ph. Houcke
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. D. Goldfain
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. P. Guyot
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Th. Helbert
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J. Laurent
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. J. F. Rey
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. D. Rouhier
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. J. Cassigneul
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. B. Marchetti
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. A. Papazian
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. M. Laurence
    View author publications

    You can also search for this author in PubMed Google Scholar

About this article

Cite this article

Houcke, P., Goldfain, D., Guyot, P. et al. Prévention des récidives de l’oesophagite par reflux par le lansoprazole: 30 mg un jour sur deux ou 15 mg tous les jours?. Acta Endosc 30, 243–253 (2000). https://doi.org/10.1007/BF03022115

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03022115

Mots-clés

Key-words

Search

Navigation