Efficacy of misoprostol and ranitidine in the prevention of duodenal ulcer
relapse and its correlation with endogenous gastric prostanoid synthesis.
Author(s): Goldin E, Karmeli F, Rachmilewitz D.
Affiliation(s): Department of Gastroenterology, Hadassah University Hospital, Hebrew University,
Hadassah Medical School, Jerusalem, Israel.
Publication date & source: 1991, Aliment Pharmacol Ther. , 5(2):173-80
We determined endogenous gastric prostaglandin synthesis and its correlation with
the prevention of duodenal ulcer relapse by misoprostol and ranitidine. Sixty-one
patients with recent endoscopically healed duodenal ulcer were randomly allocated
in a double-blind fashion for one year of treatment with misoprostol 400
micrograms nocte, ranitidine 150 mg nocte or placebo. Patients were followed
every two months. Endoscopy was repeated at six and 12 months or beforehand, if
relapse was suspected. Antral and fundic biopsies, 3-4 from each region, were
obtained at each endoscopy for determination of prostaglandin synthesis. During
the one year of treatment, 11 out of the 12 placebo treated patients flared up,
as opposed to 10 out of 25 and four out of 24 misoprostol and ranitidine treated
patients, respectively. The difference between all treatment groups was
significant (P less than 0.0001). In all subjects who flared up, pretrial
endogenous antral and fundic prostaglandin E2 synthesis were not different from
their respective synthesis in those who did not relapse.
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