Pantoprazole and Ranitidine in the Treatment of Acute Duodenal Ulcer: A Multicentre Study

BACKGROUND: Pantoprazole is a new substituted benzimidazole that inhibits the parietal cell H+,K(+)-adenosine triphosphatase. METHODS: Pantoprazole (40 mg) was compared with ranitidine (300 mg) in the treatment of acute duodenal ulcer. Two hundred and sixty-six patients with endoscopically diagnosed duodenal ulcers entered this multicentre, double-blind study. The primary efficacy variable was complete ulcer healing at 2 weeks; treatment then continued for a further 2 weeks if ulcers were unhealed. RESULTS: After 2 weeks 112 of 164 (68%) patients in the pantoprazole group had healed ulcers, compared with 36 of 81 (44%) taking ranitidine (p < 0.001). After 4 weeks the cumulative healing rates were 96% and 85% (p < 0.01). Improvement in ulcer pain was also significantly better with pantoprazole than with ranitidine (81% versus 62% with no pain at 2 weeks, p < 0.01). CONCLUSIONS: Pantoprazole is clinically superior to ranitidine in the treatment of acute duodenal ulcer, in terms of both healing and symptom relief.