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Introduction: Relapse of erosive oesophagitis occurs in almost all patients if treatment is stopped after initial healing.

The comparative efficacy of twice daily regimens of 40 mg famotidine (group 1), 20 mg famotidine (group 2), and 150 mg ranitidine (group 3) was investigated in a double-blind randomized study of parallel groups of patients with endoscopically documented erosive esophagitis. Patients were enrolled at 29 centers in 19 countries and treated for 6 to 12 weeks until healing, defined as complete resolution of visible ulceration or erosion of the esophageal mucosa, demonstrated by repeat endoscopy. Healing occurred in 71% of 175 group-1 patients, 68% of 93 group-2 patients, and 60% of 172 group-3 patients; the difference between groups 1 and 3 was significant (P ≤ 0.05). The three treatments produced similar levels of global symptomatic improvement and relief of daytime and nighttime heartburn. All treatments were well tolerated. These results support the hypothesis that reduction of esophageal acid exposure by 40 mg famotidine twice daily produces healing of lesions in patients with erosive esophagitis and is more effective than regimens that provide lesser reductions in esophageal acid exposure time.