Lansoprazole 30 mg daily versus ranitidine 150 mg bd in the treatment of acid-related dyspepsia in general practice

Aim: To compare lansoprazole 30 mg daily with ranitidine 150 mg b.d. in the treatment of acid-related dyspepsia in general practice. Methods: In a double-blind, parallel group, randomized, multicentre study conducted in 32 general practices in the UK, 213 patients were randomized to receive lansoprazole 30 mg daily, and 219 to receive ranitidine 150 mg b.d., for 4 weeks. All patients had experienced symptoms of reflux-like or ulcer-like dyspepsia on at least 4 of the 7 days prior to the study; 75% had experienced dyspepsia in the past, and 74 of the lansoprazole patients and 77 of the ranitidine patients had documented histories of acid-related disorders, investigated by either radiology or endoscopy. Results: After 2 weeks 55% of the lansoprazole patients and 33% of the ranitidine group were symptom-free (P = 0.001, chi(2) = 7.12) with corresponding 4-week figures of 69% and 44%, respectively (P = 0.001, chi(2) = 18.03), Similar figures were found at both 2 and 4 weeks for daytime and night-time heartburn and epigastric pain scores; in the lansoprazole group, at 4 weeks, 80% of patients were free of daytime heartburn and 81% of night-time epigastric pain, compared with 55% (p = 0.001, chi(2) = 15.44) and 65% (P = 0.01, chi(2) = 6.10) in the ranitidine group. Conclusion: Superior symptom relief for patients presenting with ulcer-like and reflux-like symptoms in general practice is provided by lansoprazole 30 mg daily compared with ranitidine 150 mg twice daily.