Comparison of Ranitidine and High-Dose Antacid in the Treatment of Prepyloric or Duodenal Ulcer

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Abstract
Patients (119) with endoscopically confirmed prepyloric (n = 59) or duodenal (n = 60) ulcer were stratified for ulcer location before entering a randomized double-blind trial comparing ranitidine (150 mg twice daily) and a potent liquid antacid (Novaluzid; 10 ml 7 times daily, with a neutralizing capacity of 600 mmol H-). Patients (54) with prepyloric (26 receiving ranitidine) and 53 patients with duodenal ulcer (28 receiving ranitidine) completed the trial in accordance with the protocol. The 4 and 6 wk healing rates for prepyloric ulcers were 54%, 68% and 61%, vs. 69%, 79% and 74% for the raniditine, the antacid and whole groups, respectively. For duodenal ulcers these figures were 89%, 84% and 87%, vs. 100%, 96% and 98% for the ranitidine, antacid and whole groups, respectively. Differences in healing rates between treatments were statistically insignificant within strata for ulcer type, but healing rates for prepyloric ulcers were significantly lower than for duodenal ulcers (P < 0.002). A significant early pain relief was found in all groups and side effects, including diarrhea, were rare. These 2 ulcer treatment modalities appear to be equally effective in the short-term. The data emphasize the need for proper stratification of prepyloric and duodenal ulcers in clinical trials of ulcer healing.