Randomized Trial of Omeprazole or Ranitidine Versus Placebo in the Prevention of Chemotherapy-Induced Gastroduodenal Injury

Abstract

Omeprazole is effective in preventing chemotherapy-induced gastroduodenal injury. Ranitidine is effective in reducing the frequency of ulcers and upper gastrointestinal symptoms but is not effective in preventing the global endoscopic worsening caused by chemotherapy. The different efficacy of omeprazole and ranitidine can be explained by their different pharmacodynamics.

Proton Pump Inhibitors in cancer patients: How useful they are? A review of the most common indications for their use

“…No severe complications were reported in any treatment arm. A second study, enrolling 238 patients with similar characteristics, compared the administration of Omeprazole 20 mg daily with Ranitidine 300 mg daily, with placebo (Sartori et al, 2000). Again, the results of Omeprazole were significantly better than placebo both in terms of endoscopic findings and of symptoms' control.…”

“…Endoscopically-documented mucosal damage was evident in nearly half of the patients after the second cycle in the non-Omeprazole arms. Some limitations of the two chemotherapy trials (Sartori et al, 1996(Sartori et al, , 2000, together with additional concerns, should be taken into account. First of all, gastric damage did not translate into clinically relevant consequences, such as bleeding, anemia, or perforation.…”

Alimentary mucositis: putting the guidelines into practice

“…Two studies published by Sartori et al [13,14] showed that omeprazole and ranitidine reduced epigastric pain and decreased gastric and duodenal erosions.…”

Prise en charge préventive et curative des mucites du tractus digestif (mucites buccopharyngées, œsogastro-intestinales et anorectales)

“…Traitement préventif [36] Traitement préventif mucite gastro-intestinale le sucralfate n'est pas recommandé pour réduire • les effets secondaires liés à la radiothérapie. Elle n'empêche pas la diarrhée aiguë chez les patients atteints de tumeurs malignes du bassin (exemple : métastases osseuses de cancer du sein) soumis à une radiothérapie externe.…”