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A comparison of omeprazole with ranitidine for ulcers associated with nonsteroidal antiinflammatory drugs

dc.contributor.authorYeomans N.D.
dc.contributor.authorTulassay Z.
dc.contributor.authorJuhasz L.
dc.contributor.authorRacz I.
dc.contributor.authorHoward J.M.
dc.contributor.authorVan Rensburg C.J.
dc.contributor.authorSwannell A.J.
dc.contributor.authorHawkey C.J.
dc.date.accessioned2011-05-15T16:17:31Z
dc.date.available2011-05-15T16:17:31Z
dc.date.issued1998
dc.identifier.citationNew England Journal of Medicine
dc.identifier.citation338
dc.identifier.citation11
dc.identifier.issn00284793
dc.identifier.other10.1056/NEJM199803123381104
dc.identifier.urihttp://hdl.handle.net/10019.1/14249
dc.description.abstractBackground: Suppressing acid secretion is thought to reduce the risk of ulcers associated with regular use of nonsteroidal antiinflammatory drugs (NSAIDs), but the best means of accomplishing this is uncertain. Methods: We studied 541 patients who required continuous treatment with NSAIDs and who had ulcers or more than 10 erosions in either the stomach or duodenum. Patients were randomly assigned to double-blind treatment with omeprazole, 20 mg or 40 mg orally per day, or renitidine, 150 mg orally twice a day, for four or eight weeks, depending on when treatment was successful (defined as the resolution of ulcer and the presence of fewer then five erosions in the stomach and fewer than five erosions in the duodenum, and not more then mild dyspepsia). We randomly assigned 432 patients in whom treatment was successful to maintenance treatment with either 20 mg of omeprazole per day or 150 mg of ranitidine twice a day for six months. Results: At eight weeks, treatment was successful in 80 percent (140 of 174) of the patients in the group given 20 mg of omeprazole per day, 79 percent (148 of 187) of those given 40 mg of omeprazole per day, and 63 percent (110 of 174) of those given ranitidine (P<0.001 for the comparison with 20 mg of omeprazola and P=0.001 for the comparison with 40 mg of omeprazole). The rates of healing of all types of lesions were higher with omeprazole than with ranitidine. During maintenance therapy, the estimated proportion of patients in remission at the end of six months was 72 percent in the omeprazole group and 59 percent in the ranitidine group. The rates of adverse events were similar between groups during both phases. Both medications were well tolerated. Conclusions: In patients who use NSAIDs regularly, omeprezole healed and prevented ulcers more effectivity than did ranitidine.
dc.subjectdiclofenac
dc.subjectindometacin
dc.subjectnaproxen
dc.subjectnonsteroid antiinflammatory agent
dc.subjectomeprazole
dc.subjectprednisolone
dc.subjectranitidine
dc.subjecturease
dc.subjectadult
dc.subjectaged
dc.subjectarticle
dc.subjectclinical trial
dc.subjectcontrolled study
dc.subjectdouble blind procedure
dc.subjectdrug efficacy
dc.subjectduodenum ulcer
dc.subjectendoscopy
dc.subjectfemale
dc.subjecthelicobacter pylori
dc.subjecthuman
dc.subjecthuman tissue
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectmulticenter study
dc.subjectoral drug administration
dc.subjectpriority journal
dc.subjectprognosis
dc.subjectrandomized controlled trial
dc.subjectstomach biopsy
dc.subjectstomach erosion
dc.subjectstomach ulcer
dc.subjectulcer healing
dc.subjectAdult
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectAnti-Inflammatory Agents, Non-Steroidal
dc.subjectAnti-Ulcer Agents
dc.subjectDouble-Blind Method
dc.subjectDuodenal Ulcer
dc.subjectFemale
dc.subjectHistamine H2 Antagonists
dc.subjectHumans
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectOmeprazole
dc.subjectPrognosis
dc.subjectProton Pumps
dc.subjectRanitidine
dc.subjectRemission Induction
dc.subjectStomach Ulcer
dc.titleA comparison of omeprazole with ranitidine for ulcers associated with nonsteroidal antiinflammatory drugs
dc.typeArticle
dc.description.versionArticle


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