title: Superiority of lansoprazole vs ranitidine in healing nonsteroidal anti-inflammatory drug-associated gastric ulcers: results of a double-blind, randomized, multicenter study. NSAID-Associated Gastric Ulcer Study Group.
abstract: BACKGROUND
  The usefulness of nonsteroidal anti-inflammatory drugs (NSAIDs) is limited by adverse gastrointestinal tract events.
  
  
  OBJECTIVE
  To identify the optimal antisecretory therapy for healing of gastric ulcer in patients using NSAIDs and the impact of concurrent Helicobacter pylori infection on ulcer healing.
  
  
  METHODS
  Prospective, double-blind, multicenter, parallel-group study.
  
  
  METHODS
  Gastroenterology practices in ambulatory and referral center settings.
  
  
  METHODS
  Three hundred fifty-three patients with an active, nonmalignant gastric ulcer at least 5 mm in diameter confirmed by endoscopy and biopsy and who continued to receive stable doses of NSAIDs.
  
  
  METHODS
  Patients were randomized to receive ranitidine hydrochloride, 150 mg twice daily, or lansoprazole, 15 mg or 30 mg once daily, for 8 weeks.
  
  
  METHODS
  Healing was assessed by endoscopy at 4 and 8 weeks in an intent-to-treat population. Helicobacter pylori status was assessed by histological examination.
  
  
  RESULTS
  After 8 weeks of treatment, healing was observed in 61 (53%) of 115, 81 (69%) of 118, and 85 (73%) of 117 patients receiving ranitidine lansoprazole, 15 mg, and lansoprazole, 30 mg, respectively (P<.05 for ranitidine vs both lansoprazole doses; 95% confidence interval, 3.2-28.0 for ranitidine vs lansoprazole, 15 mg, and 7.4-31.8 for ranitidine vs lansoprazole, 30 mg). The gastric ulcer healing rates were similar between H pylori-infected and -noninfected patients, with a statistically significant increase with the use of lansoprazole vs ranitidine.
  
  
  CONCLUSIONS
  In patients who require continuous treatment with NSAIDs, lansoprazole is superior to ranitidine for healing of NSAID-associated gastric ulcers. Healing is not delayed by the presence of H pylori infection.
authors.affiliation: Department of Medicine, University of Connecticut Health Center, Farmington, USA. agraw001@mc.duke.edu
authors.forename: N M
authors.initials: NM
authors.lastname: Agrawal
authors.forename: D R
authors.initials: DR
authors.lastname: Campbell
authors.forename: M A
authors.initials: MA
authors.lastname: Safdi
authors.forename: N L
authors.initials: NL
authors.lastname: Lukasik
authors.forename: B
authors.initials: B
authors.lastname: Huang
authors.forename: M M
authors.initials: MM
authors.lastname: Haber
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects*; D000897:Anti-Ulcer Agents / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy; D016480:Helicobacter pylori / Q000187:drug effects; D006801:Humans; D064747:Lansoprazole; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D054328:Proton Pump Inhibitors; D011899:Ranitidine / Q000009:adverse effects / Q000627:therapeutic use*; D013276:Stomach Ulcer / Q000139:chemically induced / Q000188:drug therapy*; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors; D064747:Lansoprazole; D011899:Ranitidine; D009853:Omeprazole