The efficacy of hydrotalcite compared with OTC famotidine in the on-demand treatment of gastroesophageal reflux disease: a non-inferiority trial.

ABSTRACT

BACKGROUND: Antacids and gastric acid inhibitors are effective in the self-treatment of gastroesophageal reflux disease (GERD). The aim was to investigate onset of action of the antacid hydrotalcite compared with the OTC H2-receptor antagonist famotidine in patients suffering from heartburn. MATERIAL/METHODS: A total of 53 patients with endoscopically diagnosed GERD grade 0-1 took part in this open, randomized, parallel-group comparison trial 26 patients received a single dose of 1000 mg hydrotalcite and 27 patients a single dose of 10 mg famotidine on the occasion of a symptomatic reflux episode. Severity of heartburn and accompanying symptoms were documented on a four-point verbal rating scale (VRS) at baseline and up to four hours after intake. Onset and duration of action were defined by the number of patients experiencing improvement of heartburn from severe or moderate to mild or none compared with baseline. RESULTS: Hydrotalcite was significantly superior (p<0.001) to famotidine in increasing the proportion of responders within the first 45 minutes, starting 10 minutes after drug intake. Between 60 and 120 minutes, both compounds showed equal efficacy. Three hours after intake the response rate was 90.9% for hydrotalcite and 92.0% for famotidine. After four hours the response rates were 86.4% for hydrotalcite and 96.0% for famotidine. In both groups, no adverse events were observed. CONCLUSIONS: The results indicate that hydrotalcite relieves the symptoms of gastroesophageal reflux faster than OTC famotidine and is equally effective for up to two hours. It is a safe and effective self-medication for on-demand treatment of heartburn.