NEW YORK -- Lansoprazole is superior to ranitidine for healing NSAID-related gastric ulcers in patients who must continue their anti-inflammatory medication, Dr. Jay L. Goldstein reported at the annual meeting of the American College of Gastroenterology.
He reported on a 47-site randomized double-blind clinical trial in which 342 such patients received 8 weeks of lansoprazole at 15 or 30 mg daily, or ranitidine at 150 mg b.i.d. All had an endoscopically proved gastric ulcer at least 5 mm in size.
Patients on either dose of lansoprazole had significantly greater endoscopic healing rates at both 4 and 8 weeks than those on ranitidine. They also reported fewer days or nights with abdominal pain. (See chart below.) Self-reported pain scores were significantly lower with the proton pump inhibitor, too, said Dr. Goldstein of the University of Illinois, Chicago.
The bigger the ulcer at baseline, the lower the healing rate with ranitidine. In contrast, ulcer size didn't have a significant impact on lansoprazole healing rates.
Helicobacter pylori status did not affect lansoprazole's ulcer healing rate. An earlier large trial of omeprazole for NSAID-related ulcer healing showed greater success in H. pylori-positive patients.
"I can't explain the difference between the two studies," he said. "In my practice, I do test for H. pylori if I find an ulcer, and if the patient is positive, I eradicate it. Whether that influences the healing rate is yet to be determined."
The prevalence of endoscopic ulcers among chronic NSAID users is 10-30 times greater than in the general population, while the risk of symptomatic adverse GI events is from three to eight times higher.
NSAID users present with symptomatic ulcers at a rate of 1%-2% per year. And many need to continue NSAID therapy during ulcer therapy, placing them at increased risk for nonhealing.
COPYRIGHT 2001 International Medical News Group
COPYRIGHT 2001 Gale Group
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