Hiroaki Nema1, Mototsugu Kato. 1. Department of Internal Medicine, Teishinkai Hospital, North 44, East 8, Higashi-ku, Sapporo, Hokkaido 007-0844, Japan.
Abstract
AIM: To compare the therapeutic effects of proton pump inhibitors (PPI) and histamine 2 receptor antagonists (H2RA) on gastroduodenal ulcers under continuous use of low-doseaspirin. METHODS:Sixty patients who had a gastroduodenal ulcer on screening endoscopy but required continuous use of low-doseaspirin were randomly assigned to receive PPI (lansoprazole 30 mg, n = 30) or H2RA (famotidine 40 mg or if famotidine had been administered before assignment, ranitidine 300 mg, n = 30). The therapeutic effects were evaluated by endoscopy after 8-wk treatment. The presence or absence of Helicobacter pylori (H. pylori) was determined by urea breath test before treatment. Abdominal symptoms were compared with the gastrointestinal symptom rating scale (GSRS) questionnaire before and after treatment. RESULTS:Twenty-six patients in the PPI group and 26 patients in the H2RA group, excluding dropouts, were analyzed. There were no significant differences in median age, sex, underlying disease, smoking status, H. pylori infection, prevalence of ulcers before treatment, and lesion site between the two groups. The therapeutic effects were endoscopically evaluated as healed in 23 patients (88.5%) and not healed in 3 patients in the PPI group and as healed in 22 patients (84.6%) and not healed in 4 patients in the H2RA group. Abdominal symptoms before treatment were uncommon in both groups; the GSRS scores were not significantly reduced after treatment as compared with before treatment. CONCLUSION: The healing rate of gastroduodenal ulcers during continuous use of low-dose aspirin was greater than 80% in both the PPI group and the H2RA group, with no significant difference between the two groups.
RCT Entities:
AIM: To compare the therapeutic effects of proton pump inhibitors (PPI) and histamine 2 receptor antagonists (H2RA) on gastroduodenal ulcers under continuous use of low-dose aspirin. METHODS: Sixty patients who had a gastroduodenal ulcer on screening endoscopy but required continuous use of low-dose aspirin were randomly assigned to receive PPI (lansoprazole 30 mg, n = 30) or H2RA (famotidine 40 mg or if famotidine had been administered before assignment, ranitidine 300 mg, n = 30). The therapeutic effects were evaluated by endoscopy after 8-wk treatment. The presence or absence of Helicobacter pylori (H. pylori) was determined by urea breath test before treatment. Abdominal symptoms were compared with the gastrointestinal symptom rating scale (GSRS) questionnaire before and after treatment. RESULTS: Twenty-six patients in the PPI group and 26 patients in the H2RA group, excluding dropouts, were analyzed. There were no significant differences in median age, sex, underlying disease, smoking status, H. pyloriinfection, prevalence of ulcers before treatment, and lesion site between the two groups. The therapeutic effects were endoscopically evaluated as healed in 23 patients (88.5%) and not healed in 3 patients in the PPI group and as healed in 22 patients (84.6%) and not healed in 4 patients in the H2RA group. Abdominal symptoms before treatment were uncommon in both groups; the GSRS scores were not significantly reduced after treatment as compared with before treatment. CONCLUSION: The healing rate of gastroduodenal ulcers during continuous use of low-dose aspirin was greater than 80% in both the PPI group and the H2RA group, with no significant difference between the two groups.
Authors: A Lanas; E Bajador; P Serrano; J Fuentes; S Carreño; J Guardia; M Sanz; M Montoro; R Sáinz Journal: N Engl J Med Date: 2000-09-21 Impact factor: 91.245
Authors: H Tahir; K Sumii; K Haruma; A Tari; N Uemura; H Shimizu; M Sumioka; Y Inaba; T Kumamoto; Y Matsumoto Journal: Hiroshima J Med Sci Date: 1984-06
Authors: N D Yeomans; Z Tulassay; L Juhász; I Rácz; J M Howard; C J van Rensburg; A J Swannell; C J Hawkey Journal: N Engl J Med Date: 1998-03-12 Impact factor: 91.245
Authors: Donald R Campbell; Marian M Haber; Eric Sheldon; Cyndy Collis; Nancy Lukasik; Bidan Huang; Jay L Goldstein Journal: Am J Gastroenterol Date: 2002-09 Impact factor: 10.864