[Drug therapy of peptic ulcer. What is coming up?]

Prostaglandin-E analogues inhibit gastric acid secretion after oral administration. Therefore, these drugs are tested in clinical trials and one of them--Misoprostol--has recently been registered. With regard to healing rate of peptic ulcers and improvement of clinical signs and symptoms the prostaglandin analogues are superior to placebo but only equally effective or even slightly inferior to H2-receptor blockers. Side effects such as diarrhea or uterotropic actions will probably limit their broad application. The exact therapeutic effectiveness of prostaglandin analogues in treatment of peptic ulcer remains to be evaluated in greater detail. The substituted benzimidazole omeprazole is the first drug which exerts a long lasting and almost complete suppressive effect on gastric acid secretion in humans. This unique inhibition leads to a significant and more rapid healing rate of duodenal ulcers compared to treatment with H2-blockers. Additionally, peptic ulcers resistant to H2-blocker therapy can be treated effectively with omeprazole. In spite of these promising results the exact therapeutic effectiveness of this drug requires further evaluation.