Background: Suppression of gastric acid production has been effective in treating the symptoms, as well as healing lesions in reflux esophagitis. Both ranitidine, a H2- receptor blocker and pantoprazole, a proton pump inhibitor have been used for the treatment of reflux esophagitis. No data is available, that compares these two agents. This paper aims to systematically review the studies which compare pantoprazole with ranitidine.
Methods: Studies comparing pantoprazole with ranitidine in patients with reflux esophagitis of grade I-III in Savory-Miller classification were identified through electronic literature searches of MEDLINE, EMBASE, Scopus, clinicaltrials.gov, and the Cochrane library. Study-specific odds ratios (ORs) were calculated and combined using a random-effects model meta-analysis of multiple studies.
Results: In total, 596 patients from 4 studies were analyzed. Endoscopically-evident healing of esophageal ulcer after 4 weeks of treatment was present in 219 of 295 (74.32%) patients treated with pantoprazole and 160 of 301 (53.15%) patients treated with ranitidine (OR: 2.64, 95% CI: 1.15 to 6.07, p= 0.02). Healing of esophageal lesions at 8 weeks was present in 249 of 284 (87.67%) patients treated with pantoprazole and 184 of 288(63.88%) patients treated with ranitidine (OR: 4.35, 95% CI: 2.78 to 6.79, P < 0.00001).
Conclusions: Pantoprazole was shown to be more effective in treating the lesions and symptoms of reflux esophagitis compared to ranitidine. Given the recent concern for carcinogenic potential of some ranitidine products, our studies further highlight the importance of using pantoprazole over ranitidine.