Controlled trial of Pyrogastrone and cimetidine in the treatment of reflux oesophagitis

Eighty patients with reflux oesophagitis were randomised to receive either Pyrogastrone five tablets daily or cimetidine 400 mg twice daily for six weeks, extended to 12 if necessary. At six weeks, 49% of the Pyrogastrone treated subjects and 37% of the cimetidine treated subjects were healed. After 12 weeks the cumulative healing rates were 64% for Pyrogastrone and 66% for cimetidine. Compared with baseline both drugs achieved similarly significant improvements in symptom score, endoscopic and histological grading even in those who did not heal completely. Response was not related to length of symptoms or initial severity of oesophagitis. Eleven of 25 (44%) patients healed with Pyrogastrone relapsed within one year compared with 15 of 27 (56%) healed with cimetidine. Although this trend in favour of Pyrogastrone was not significant at one year the early relapse rate was significantly greater in cimetidine treated subjects. At six weeks, five cimetidine treated subjects had relapsed compared with none in the Pyrogastrone group (p=0.05). This study shows that Pyrogastrone and cimetidine are equally effective in the healing of oesophagitis and raises the possibility that Pyrogastrone has marginal benefits in terms of time to relapse.