Omeprazole in the treatment of peptic ulcers resistant to H2-receptor antagonists

Thirty patients with peptic ulcers resistant to at least 8 weeks of continuous therapy with full-dose H2-receptor antagonists alone or followed by other anti-ulcer drugs, were treated with the gastric proton pump inhibitor omeprazole (40 mg), administered orally once daily for up to 8 weeks. The study design was non-comparative and open; healing was verified by endoscopy. After only 2 weeks of treatment, 21 out of 23 (91%) duodenal ulcer patients were healed, as well as 2 out of 2 patients with both duodenal and gastric ulcer and 1 out of 3 patients with prepyloric ulcer. After 4 weeks, all duodenal ulcers, 1 out of 2 gastric ulcers and 2 out of 3 pre-pyloric ulcers were healed. A further month of therapy healed the gastric ulcer to give an overall healing rate of 97% and leaving only one patient (pre-pyloric ulcer) unhealed at the end of the study. Of 19 patients suffering ulcer symptoms at entry, only two patients reported any symptoms at 2 weeks and one of these (who remained unhealed) continued to have symptoms throughout the study. One patient reported mild asthenia; otherwise, no clinical or biochemical side-effects were recorded. It is concluded that omeprazole is highly effective in healing refractory peptic ulcers.