Treatment of patients with heartburn without endoscopic evaluation: on‐demand treatment after effective continuous administration of lansoprazole 15 mg

Summary Background : Relapse is frequent after initial treatment for gastro‐oesophageal reflux. An alternative strategy to intermittent or continuous therapy may be on‐demand treatment. Aim : To compare the efficacy and safety of on‐demand lansoprazole 15 mg and placebo treatment in patients with gastro‐oesophageal reflux. Methods : This was a multicentre, randomized, double‐blind study in two parallel groups of patients. In the acute study phase, all included patients (n = 203) were treated with lansoprazole 15 mg (once per day) for 4 weeks. At week 4, asymptomatic patients entered the 6‐month, on‐demand, follow‐up phase and were randomized to receive either lansoprazole 15 mg (once per day) or placebo. Results : A higher percentage of patients in the lansoprazole group completed the 6‐month follow‐up than in the placebo group [81% vs. 61% (P = 0.003)]. Only 16% of patients in the lansoprazole group discontinued the study for insufficient control of heartburn vs. 28% in the placebo group (P = 0.046). The mean daily intake in patients who completed the study was 1–5 capsules/day in the lansoprazole 15 mg group. Conclusions : On‐demand treatment with lansoprazole 15 mg in symptomatic patients after short‐term, continuous treatment is a promising therapeutic alternative to intermittent and continuous treatment to maintain heartburn control in patients with gastro‐oesophageal reflux.