[Variations of plasma gastrin (basal and postprandial) in ththtreatmentof duodenal ulcer with either enprostil or ranitidine. Correlations with rates of relapse].
Enprostil, a synthetic E2-prostaglandin efficacious for duodenal ulcer healing, presents both antisecretory and antigastrinic effects. This is at variance with the elevation of plasma gastrin observed with ranitidine. OBJECTIVE--This leads us to compare enprostil and ranitidine on the following points: a) variations of plasma gastrin (basal and postprandial) parameters over a 6-week conventional treatment; b) correlation studies between ulcer relapses (frequency and temporal evolution) after treatment discontinuation and various gastrinic criteria. METHODS--Among a group of 642 patients followed for ulcer relapse, 165 were considered for gastrin (78 of the "Enprostil" group and 87 of the "Ranitidine" group). RESULTS--Initially, both populations were comparable for clinical and plasma gastrin parameters. After 6 weeks of treatment, the increases in the various gastrin parameters (basal, postprandial, peak, integraded) were significantly greater and the absolute values higher (Wilcoxon, P < 0.001) with ranitidine than with enprostil. No correlation was found between relapse occurrence after drug discontinuation and these gastrin parameters. CONCLUSIONS--Ranitidine hypergastrinemia seems directly related to gastric hyposecretion whereas its absence with enprostil is likely more dependent upon a specific antigastrinic activity than on a reduced antisecretory activity. Those differences in mechanism of action have no consequence on the stability of ulcer obtained by either drug.
Bado
A
A
INSERM U.10, Hôpital Bichat, Paris.
Corrion
F
F
Bernades
P
P
Chevalier
T
T
Galmiche
J P
JP
Laverdant
C
C
Mignon
M
M
Minaire
Y
Y
Pariente
A
A
Vicari
F
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D004381:Duodenal Ulcer / Q000097:blood* / Q000188:drug therapy; D016620:Enprostil / Q000627:therapeutic use*; D005260:Female; D005755:Gastrins / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011899:Ranitidine / Q000627:therapeutic use*; D012008:Recurrence
D005755:Gastrins; D011899:Ranitidine; D016620:Enprostil
Variations de la gastrine plasmatique (basale et post-prandiale) au cours de traitements de l'ulcère duodénal par l'enprostil ou la ranitidine. Corrélations avec les taux de rechute.