Comparison of the effectiveness of geranylgeranylacetone with cimetidine in gastritis patients with dyspeptic symptoms and gastric lesions: a randomized, double-blind trial in Japan.
OBJECTIVE
Controversy remains regarding the treatment of choice for chronic gastritis patients with dyspeptic symptoms when Helicobacter pylori eradication is not indicated or fails for their gastric lesions. A multicenter, randomized, double-blind trial was performed to compare the effectiveness of geranylgeranylacetone (GGA), a mucoprotective drug, against cimetidine (CIT), an H(2)-receptor antagonist, on the treatment of erosions and petechial hemorrhage in H. pylori-infected patients with dyspeptic symptoms.


METHODS
128 H. pylori-positive gastritis patients with mucosal erosions and/or petechial hemorrhage were randomized to receive 150 mg GGA t.i.d. or 400 mg CIT b.i.d. for 2 weeks. Improvement and cure rates on endoscopic findings, symptom disappearance rates, and changes in mucosal neutrophil infiltration were compared.


RESULTS
Endoscopic improvement rates were significantly higher in the GGA group (n = 50) than in the CIT group (n = 54; 86.0 vs. 64.8%, p = 0.014). Endoscopic cure rates were also significantly higher for GGA than for CIT (80.0 vs. 55.6%, p = 0.012). Symptom disappearance rates were 52.0% for GGA and 42.6% for CIT, but the difference was not significant. There was also no significant difference in mucosal neutrophil infiltration between the groups.


CONCLUSIONS
GGA treatment appears to be more effective than CIT for chronic gastritis-associated erosion and petechial hemorrhage.
Sakamoto
Choitsu
C
Department of Internal Medicine, Division of Gastroenterology, Nippon Medical School, Tokyo, Japan. choitsu@nms.ac.jp
Ogoshi
Kazuei
K
Saigenji
Katsunori
K
Narisawa
Rintarou
R
Nagura
Hiroshi
H
Mine
Tetsuya
T
Tada
Masahiro
M
Umegaki
Eiji
E
Maekawa
Takama
T
Maekawa
Ryuichiro
R
Maeda
Kazuhiro
K
D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D002927:Cimetidine / Q000627:therapeutic use*; D004224:Diterpenes / Q000627:therapeutic use*; D004311:Double-Blind Method; D004415:Dyspepsia / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D005756:Gastritis / Q000188:drug therapy* / Q000382:microbiology; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
D000897:Anti-Ulcer Agents; D004224:Diterpenes; D002927:Cimetidine; C031049:geranylgeranylacetone