Roxatidine (150 mg, 312 patients) was compared with ranitidine (300 mg, 308 patients) in a randomized, double-blind, parallel-group, 6-week therapeutic study for the treatment of patients with uncomplicated, benign gastric ulcer disease. The study end points (verified by using endoscopy results) were fully healed ulcers at 4 or 6 weeks. The results of roxatidine therapy were comparable to those of ranitidine therapy: healing rates of 52% and 54% at week 4 and 77% and 76% at week 6 were recorded for roxatidine and ranitidine, respectively. The drugs produced comparable reductions in ulcer diameters and decreases in abdominal pain. Adverse events associated with both roxatidine (27%) and ranitidine (28%) were headache, diarrhea, and dizziness; rash was associated in 6 of 8 cases and in only 1 case with roxatidine. In this trial, roxatidine 150 mg once daily was as efficacious and safe as ranitidine 300 mg once daily for treatment of patients with uncomplicated, benign gastric ulcer disease.

Adult↗

PubMedDate not supplied

Sucralfate: the Bangkok review.

Sucralfate is a site-protective ulcer healing drug with a remarkable range of mechanisms of action. Recent studies highlight the capacity of sucralfate to bind basic fibroblast growth factor (bFGF) and deliver it in high concentration to the ulcer. Basic fibroblast growth factor stimulates the production of granulation tissue, angiogenesis and re-epithelization, thus improving the quality of ulcer healing. The effect of sucralfate in reducing parietal cell sensitivity may be another factor important in the lower relapse rate demonstrated after duodenal ulcer healing. Sucralfate has been demonstrated to be efficacious in healing both duodenal and gastric ulcers together with mild oesophagitis, and it is safe for both short-term use and maintenance. In stress ulcer prophylaxis it is as effective as acid suppression or neutralization and has the advantage of lesser rates of nosocomial pneumonia than are demonstrated with antacids or H2 antagonists. The potential advantages of sucralfate lie in the better quality of ulcer healing associated with longer duration of remission.

Clinical Trials as Topic↗

PubMedDate not supplied

Dry beriberi: unusual complication of prolonged parenteral nutrition.

An adult with Crohn's disease on home total parenteral nutrition (TPN) for 8 months presented with peripheral neuropathy and ataxia. The patient was found to be deficient of thiamine. A prompt symptomatic response to intravenous thiamine suggests that the patient had the chronic form of dry beriberi. To our knowledge, this variety of beriberi in a patient on TPN has not previously been reported.

Adult↗

PubMedDate not supplied

Changes in mucosal levels of transforming growth factor-alpha from the oxyntic region and ulcer site during duodenal ulcer healing with ranitidine or sucralfate.

Changes in the levels of transforming growth factor-alpha (TGF-alpha) in gastric mucosa during ulcer healing were studied in 24 patients with endoscopically confirmed duodenal ulcers, treated either with ranitidine (300 mg daily, at night) or with sucralfate (2 g twice daily). Endoscopic biopsies were taken from the gastric fundus and from the ulcer margin at baseline and after 7-10 days of treatment. TGF-alpha levels were determined by radioimmunoassay in paired samples from 22 patients (fundal) and 18 patients (duodenal). There were no significant changes in TGF-alpha levels in the fundus of the whole group or of either treatment group. At the ulcer site, however, there was a significant increase in TGF-alpha levels in the whole group (from 16.4 to 33 pg/mg protein (medians); P < 0.005), and an increasing trend was seen in both treatment groups but was statistically significantly only in the group treated with sucralfate (P < 0.03).

Adult↗

PubMedDate not supplied

Helicobacter pylori: therapeutic targets.

Helicobacter pylori is now considered a major pathogen of the upper gastrointestinal tract. It is seen as an important cause of peptic ulceration not associated with NSAID use. It is also increasingly linked to other diseases of the GI tract, although the relationship between the organism and conditions such as gastric cancer, non-ulcer dyspepsia and gastroesophageal reflux disease is not as clear as is the case in peptic ulcer disease. This is probably because of a lack of well-performed, statistically powerful, prospective therapeutic trials that indicate that H. pylori eradication is of benefit in these diseases. The high infection rate without overt disease seen in many populations, especially from developing countries, probably contributes to this "credibility gap." While we have excellent therapeutic regimens available at this time, rational targeting requires that the objective evidence in favor of therapeutic intervention in upper GI disease, as well as the local H. pylori epidemiology, needs to be considered.

Anti-Inflammatory Agents, Non-Steroidal↗

PubMedDate not supplied

Small bowel structure and function in pancreatic steatorrhea.

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Celiac Disease↗

PubMedDate not supplied

The H2-receptor antagonist era in duodenal ulcer disease.

This paper reviews the remarkable impact of H2-receptor antagonists on duodenal ulcer management. The development and the scientific rationale of these agents are presented, and efficacy and safety aspects in the short- and long-term treatment of duodenal ulcer disease discussed. Attention is focused on the possible role of "acid rebound" in ulcer relapse following the withdrawal of therapy and on the clinical relevance of prolonged suppression of acid secretion in patients on long-term therapy.

Duodenal Ulcer↗

PubMedDate not supplied

Helicobacter pylori: controversial and unsolved issues.

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Duodenal Ulcer↗