Abstract
In most patients duodenal ulcer is a chronicrelapsing disease. If no active maintenance treatment oreradication therapy is given after healing, around70-100% of patients have a relapse during the first year. We conducted a double-blind multicenterstudy in 472 patients with duodenal ulcer. They weretreated with omeprazole 20 mg every morning for four oreight weeks and when healed were randomly allocated to maintenance treatment with either omeprazole20 mg every morning or ranitidine 150 mg at bedtime forup to six months. The patients were assessed byendoscopy at monthly intervals until healing occurred. Thereafter scheduled endoscopy was carried outafter 1, 3, and 6 months of maintenance treatment orimmediately in the event of a suspected relapse. Healingstatus (intention to treat approach) was 87% at four weeks and 93% at eight weeks. At sixmonths the estimated remission rate was 90% foromeprazole and 82% for ranitidine (P = 0.03, 95% CI1-15%). The incidence of adverse events was similarduring the two maintenance treatments. Treatment withomeprazole 20 mg every morning maintained significantlymore patients in remission than treatment withranitidine 150 mg at bedtime.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
REFERENCES
Bigard MA, I sal JP, Galmiche JP, Ebrard F, Bader JP: Ome-prazole versus cimetidine in short-term treatment of acute duodenal ulcer. Gastroente rol Clin Biol 11:753–757, 1987
McFarland RJ, Bate son MC, Gre en JRB, et al: Omeprazole 20 mg provides quicker symptom relief and duodenal ulcer healing than ranitidine 300 mg nocte.Gastroenterology 98:278–283, 1990
Pounder RE: What is an intractable duodenal ulcer and how should it be managed? Alimen Pharmacol The r 1:439S–446S, 1987
Meyrick Thomas J, Misiewicz G: Histamine H2-receptor antagonists in the short-and long-term treatment of duodenal ulcer. Clin Gastroente rol 13( 2):501–541, 1984
Solcia E, Bordi C, Creutzfeldt W, et al: Histopathological classification of nonantral gastric endocrine growths in man. Digestion 41:185–200, 1988
Lauritsen K, Andersen BN, Laursen LS, et al: Weekend administration of omeprazole in the prevention of duodenal ulcer relapse: A double-blind comparative trial. Gastroenterology 96:A289, 1989
Bianchi-Porro G, Bolling E, Barbara L et al: Maintenance treatment with omeprazole in the prevention of duodenal ulcer relapse: A double-blind comparative trial. Digestive Diseases Week, San Antonio, Texas; May 13-16 1990, Abstract 851.
Savarino V, Sandro Mela G, Zentilin P, et al: Variability in individual response to various doses of omeprazole. Implications for antiulcer therapy. Dig Dis Sci 39:161–168, 1994
Boyd EJS, Johnston DA, Penston JG, Wormsley KG: Does maintenance therapy keep duodenal ulcers healed? Lance t 1:1324–1327, 1988
Walsh JH, Peterson WL: The treatment of Helicobacter pyloriinfection in the management. N Engl J Med 333:984–988, 1995
NIH Consensus Development Panel: Helicobacter pyloriin peptic ulcer disease. JAMA 272:65–69, 1994
Graham DY: Helicobacter pylori:Its epidemiology and its role in duodenal ulcer disease. J Gastroenterol Hepatol 6:105–113, 1991
Rauws EAJ: Reasons for failure of Helicobacte r pylori treatment. Eur J Gastroenterol Hepatol 5:325–331, 1993
Wilde MI, McTavish D: Omeprazole. An update of its pharmacology and therapeutic use in acid-related disorders. Drugs 48(1):91–132, 1994
Festen HPM: Prevention of duodenal ulcer relapse by longterm treatment with omeprazole. Scand J Gastroenterol Suppl 201:39–41, 1994
Di Mario F, Vigneri S, Termini R, e t al: Omeprazole different dosages in maintenance treatment of duodenal ulcer patients: A prospective randomised study. Proceedings of IX World Congress of Gastroenterology, Sydney, 1990
Del Piano M, Manfredda I, Montino F, Occhipinti P: The maintenance treatment of duodenal ulcer with omeprazole. Gastrointest Endosc 39:273, 1993 (abstract)
Ferrara A, Prada A, Colombo E, e t al: Maintenance treatment of duodenal ulcer with omeprazole: Three different regimens. Ital J Gastroente rol 25( suppl. 1):77, 1993 (abstract)
Khan AQ: Omeprazole in the maintenance treatment of duodenal ulcer. A prospective randomized controlled trial comparing two treatment schedules. Gastroenterology 104:A117, 1993
Kurata JH, Koch GG, Nogawa AN: Comparison of ranitidine and cime tidine ulcer maintenance therapy. J Clin Gastroenterol 9:644–650, 1987
Bianchi Porro G, Lazzaroni M, Barbara L: A controlled study of 20 mg famotidine nocte vs 150 mg ranitidine nocte for the preve ntion of duodenal ulcer re lapse. Aliment Pharmacol Ther 5:181–189, 1991
Kitler ME: Clinical Trials in duodenal ulcer disease: Focus on relapse and maintenance therapy. Gastroente rol Int 4(2): 55–59, 1991
Yeomans ND: Maintenance therapy for duodenal ulcer with proton pump blockers. J Gastroente rol Hepatol 10:110–111, 1995
Rights and permissions
About this article
Cite this article
Rojas, F.D.D., Berenguer, J., Rodrigo, L. et al. Omeprazole and Ranitidine in Long-Term Treatment of Duodenal Ulcer A Double-Blind Comparison of Length of Time in Remission. Dig Dis Sci 43, 1964–1969 (1998). https://doi.org/10.1023/A:1018882425236
Issue Date:
DOI: https://doi.org/10.1023/A:1018882425236