In this issue of the Archives, Sabesin et al1 report on the efficacy of famotidine twice-daily (BID) vs nocturnal therapy vs placebo in controlling the symptoms of gastroesophageal reflux disease (GERD) and in healing reflux esophagitis. The authors demonstrate that dosing BID is more effective than the other regimens in relieving daytime heartburn and results in greater symptom relief as manifested by reduced antacid consumption. The authors also conclude that while both doses of famotidine were more effective than placebo in relief of reflux symptoms and healing erosive esophagitis, the BID dose results in better symptom control. The proposed mechanism of this improvement seen with BID dosing was thought to be better 24-hour pH control of esophageal acid exposure time. Although the authors conclude that famotidine is effective in relieving symptoms of GERD and in healing esophagitis, only about half of the patients were symptom free or healed at
Fennerty MB, Sampliner RE. Medical Therapy for Gastroesophageal Reflux DiseaseNot All Treatments Are Equal!. Arch Intern Med. 1991;151(12):2365–2366. doi:10.1001/archinte.1991.00400120011002
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