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Is ranitidine therapy sufficient for healing peptic ulcers associated with non-steroidal anti-inflammatory drug use?

Yeomans ND, Svedberg LE, Naesdal J - Int. J. Clin. Pract. (2006)

Bottom Line: Ranitidine was more effective when NSAIDs were discontinued (healing rates reaching 95% and 100%, respectively).However, proton pump inhibitor (PPI) therapy was associated with significantly greater rates of both GU and DU healing than ranitidine; 8-week GU rates were 92% and 88% with esomeprazole 40 mg and 20 mg, respectively (vs. 74% with ranitidine, p < 0.01).NSAID-associated GU are more likely to heal when patients receive concomitant treatment with a PPI rather than ranitidine.

View Article: PubMed Central - PubMed

Affiliation: School of Medicine, University of Western Sydney, NSW, Australia. n.yeomans@uws.edu.au

ABSTRACT
Long-term use of non-steroidal anti-inflammatory drugs (NSAIDs) increases the risk of serious gastroduodenal events. To minimise these risks, patients often require concomitant acid-suppressive therapy. We conducted a literature review of clinical trials examining use of ranitidine 150 mg twice daily to heal gastroduodenal ulcers (GU) in NSAID recipients. Seven studies were identified. After 8 weeks' treatment with ranitidine, GU healing rates ranged from 50% to 74% and rates of duodenal ulcer (DU) healing ranged from 81% to 84%. Ranitidine was more effective when NSAIDs were discontinued (healing rates reaching 95% and 100%, respectively). The ulcer healing rate with sucralfate was similar to that of ranitidine. However, proton pump inhibitor (PPI) therapy was associated with significantly greater rates of both GU and DU healing than ranitidine; 8-week GU rates were 92% and 88% with esomeprazole 40 mg and 20 mg, respectively (vs. 74% with ranitidine, p < 0.01). For omeprazole, 8-week healing rates were 87% with omeprazole 40 mg and 84% with omeprazole 20 mg (vs. 64% for ranitidine, p < 0.001), and for lansoprazole the corresponding values were 73-74% and 66-69% for the 30 mg and 15 mg doses, respectively (vs. 50-53% for ranitidine, p < 0.05). In the PPI study reporting DU healing the values were 92% for omeprazole 20 mg (vs. 81% for ranitidine, p < 0.05) and 88% for omeprazole 40 mg (p = 0.17 vs. ranitidine). NSAID-associated GU are more likely to heal when patients receive concomitant treatment with a PPI rather than ranitidine.

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Related in: MedlinePlus

Four-, 8- and 12-week NSAID-associated ulcer healing rates for (A) gastric ulcers and (B) duodenal ulcers in patients taking ranitidine 150 mg twice daily
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fig01: Four-, 8- and 12-week NSAID-associated ulcer healing rates for (A) gastric ulcers and (B) duodenal ulcers in patients taking ranitidine 150 mg twice daily

Mentions: The gastric ulcer healing rates associated with the use of ranitidine in patients continuing to take NSAIDs are shown in Figure 1A. Most variation was observed for healing rates at 4 weeks, which ranged from 30% to 67%. Even after 8 weeks, endoscopic examination revealed that approximately one-quarter to one-half of patients treated with ranitidine still had unhealed ulcers (healing rates of 50–74%).


Is ranitidine therapy sufficient for healing peptic ulcers associated with non-steroidal anti-inflammatory drug use?

Yeomans ND, Svedberg LE, Naesdal J - Int. J. Clin. Pract. (2006)

Four-, 8- and 12-week NSAID-associated ulcer healing rates for (A) gastric ulcers and (B) duodenal ulcers in patients taking ranitidine 150 mg twice daily
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC1636688&req=5

fig01: Four-, 8- and 12-week NSAID-associated ulcer healing rates for (A) gastric ulcers and (B) duodenal ulcers in patients taking ranitidine 150 mg twice daily
Mentions: The gastric ulcer healing rates associated with the use of ranitidine in patients continuing to take NSAIDs are shown in Figure 1A. Most variation was observed for healing rates at 4 weeks, which ranged from 30% to 67%. Even after 8 weeks, endoscopic examination revealed that approximately one-quarter to one-half of patients treated with ranitidine still had unhealed ulcers (healing rates of 50–74%).

Bottom Line: Ranitidine was more effective when NSAIDs were discontinued (healing rates reaching 95% and 100%, respectively).However, proton pump inhibitor (PPI) therapy was associated with significantly greater rates of both GU and DU healing than ranitidine; 8-week GU rates were 92% and 88% with esomeprazole 40 mg and 20 mg, respectively (vs. 74% with ranitidine, p < 0.01).NSAID-associated GU are more likely to heal when patients receive concomitant treatment with a PPI rather than ranitidine.

View Article: PubMed Central - PubMed

Affiliation: School of Medicine, University of Western Sydney, NSW, Australia. n.yeomans@uws.edu.au

ABSTRACT
Long-term use of non-steroidal anti-inflammatory drugs (NSAIDs) increases the risk of serious gastroduodenal events. To minimise these risks, patients often require concomitant acid-suppressive therapy. We conducted a literature review of clinical trials examining use of ranitidine 150 mg twice daily to heal gastroduodenal ulcers (GU) in NSAID recipients. Seven studies were identified. After 8 weeks' treatment with ranitidine, GU healing rates ranged from 50% to 74% and rates of duodenal ulcer (DU) healing ranged from 81% to 84%. Ranitidine was more effective when NSAIDs were discontinued (healing rates reaching 95% and 100%, respectively). The ulcer healing rate with sucralfate was similar to that of ranitidine. However, proton pump inhibitor (PPI) therapy was associated with significantly greater rates of both GU and DU healing than ranitidine; 8-week GU rates were 92% and 88% with esomeprazole 40 mg and 20 mg, respectively (vs. 74% with ranitidine, p < 0.01). For omeprazole, 8-week healing rates were 87% with omeprazole 40 mg and 84% with omeprazole 20 mg (vs. 64% for ranitidine, p < 0.001), and for lansoprazole the corresponding values were 73-74% and 66-69% for the 30 mg and 15 mg doses, respectively (vs. 50-53% for ranitidine, p < 0.05). In the PPI study reporting DU healing the values were 92% for omeprazole 20 mg (vs. 81% for ranitidine, p < 0.05) and 88% for omeprazole 40 mg (p = 0.17 vs. ranitidine). NSAID-associated GU are more likely to heal when patients receive concomitant treatment with a PPI rather than ranitidine.

Show MeSH
Related in: MedlinePlus