A double-blind, comparative trial was conducted to compare the effect of cisapride with ranitidine in patients with reflux oesophagitis in terms of symptomatic improvement and endoscopic healing.

A total of 40 patients with gastro-esophageal reflux disease (GERD) and oesophagitis, confirmed by endoscopy (grades I to III by the Savary-Miller classification), were randomly assigned to treatment with cisapride 10 mg q.d.s. or ranitidine 150 mg b.d. for a duration of 8 weeks. Upper gastrointestinal endoscopy was performed at study entry and at completion.

Thirty seven patients completed the trial - 18 in the cisapride group and 19 in the ranitidine group. Three patients were withdrawn from the study.

• The results with regard to symptomatic and endoscopic improvement were comparable in the two study groups.
• Both the drugs effectively controlled the symptoms of acid regurgitation, retrosternal pain, retrosternal burning, epigastric fullness and discomfort (pain, burning, sense of pressure) (Table), and healed esophagitis.
• Symptoms were in remission 1 month after treatment in the majority of patients, except for a few exceptions.
• Both the drugs were tolerated comparably, and adverse effects were minimal.

Table. Symptom scores in study groups at baseline, week 8 and follow-up

Both cisapride and ranitidine were comparable in their therapeutic effect with regard to symptomatic improvement and endoscopic healing in patients with mild to moderate GERD.

Source: Arvanitakis C, Nikopoułos A, Theoharidis A, et al. Cisapride and ranitidine in the treatment of gastro-oesophageal reflux disease--a comparative randomized double-blind trial. Aliment Pharmacol Ther. 1993 Dec;7(6):635-41.