How Long Does H₂RA Therapy Control Nocturnal Acid Breakthrough?

A nocturnal dose of a histamine₂-receptor antagonist (H₂RA) is commonly added to proton-pump inhibitor (PPI) therapy for patients with persistent symptoms of gastroesophageal reflux disease (GERD). This practice is based, in part, on the observation that patients on twice-daily PPI therapy evidence persistent gastric acidity at night (nocturnal acid breakthrough, or NAB). NAB has been defined as the presence of intragastric pH below 4 for longer than 1 hour overnight during twice-daily PPI therapy. Although addition of an H₂RA to a twice-daily PPI regimen has been shown to control NAB, the long-term efficacy of H₂RAs for pH control is not known. In this study, researchers examined long-term H₂RA therapy in 23 healthy volunteers and 20 GERD …