Effect of Omeprazole and Ranitidine on Ulcer Healing and Relapse Rates in Patients with Benign Gastric Ulcer

Abstract

Omeprazole blocks the action of H+,K+-ATPase in the gastric mucosa and thus inhibits the secretion of hydrochloric acid. We conducted a double-blind multicenter study (45 centers in 13 countries) of 602 patients with benign gastric or prepyloric ulcers to compare the effectiveness of omeprazole (20 mg once daily, 203 patients, or 40 mg once daily, 194 patients) and ranitidine, an H2-receptor antagonist (150 mg twice daily, 205 patients) in promoting ulcer healing and to evaluate the pattern of ulcer relapse during a six-month follow-up. Healing occurred at four weeks in 80 percent of the patients receiving 40 mg of omeprazole, 69 percent of those receiving 20 mg of omeprazole, 69 percent of those receiving ranitidine. At eight weeks, the corresponding figures were 96, 89, and 85 percent. A multivariate analysis of ulcer healing showed that at four weeks the ulcers of significantly more patients receiving omeprazole had healed as compared with patients receiving ranitidine (omeprazole, 40 mg, vs. ranitidine, P less than 0.0005; omeprazole, 20 mg, vs. ranitidine, P = 0.01). At eight weeks, the 40-mg dose of omeprazole was significantly more effective than ranitidine (P = 0.001) or the 20-mg dose of omeprazole (P = 0.03). Ulcer symptoms were relieved faster with omeprazole. In 68 patients receiving concurrent nonsteroidal antiinflammatory drugs, the healing rates at four weeks were 81 percent in the group receiving 40 mg of omeprazole, 61 percent in the group receiving 20 mg, and 32 percent in the group receiving ranitidine; at eight weeks, the corresponding figures were 95, 82, and 53 percent. During the six-month follow-up period (without treatment), significantly more patients in the omeprazole groups were free of symptoms and ulcers than in the ranitidine group. We conclude that in the dose used, omeprazole is superior to ranitidine in the treatment of benign gastric ulcers.

Healing of Benign Gastric and Prepyloric Ulcers: A Prospective, Endoscopy-Controlled, Randomized, Double-Blind, Canadian Multicentre Study of Omeprazole 20 and 40 mg Daily and Rantidine 150 mg Twice a Day

“…These results a rc similar to the data from the international study (27) and tlo not indicate a difference between North America and Europe in the reporting of hea ling rates. For a period of four co eight weeks, treatment with omeprazole was shown to be safe.…”

A guideline for the treatment and prevention of nsaid-induced ulcers

“…Generally, healing rates were better for all treatments when NSAIDs were discontinued, but satisfactory healing still occurred with prolonged therapy when it was necessary to continue NSAID treatment. Healing rates in patients taking omeprazole were significantly better than those in patients taking ranitidine when NSAIDs were continued (25,26,(82)(83)(84). In an uncontrolled study, famotidine 40 mg/day was given to 71 patients with endoscopicallyproven GU for 8 wk.…”

Quercetin and Ellagic Acid in Gastric Ulcer Prevention: An Integrated Scheme of the Potential Mechanisms of Action From in Vivo Study

“…The degenerative parts of the mucosa displayed weak stainability. Walan et al [101] have been showed that Omeprazole blocks the action of H + , K + ATPase in the gastric mucosa and thus depletes the secretion of hydrochloric acid.…”