Treatment of peptic ulcer induced by non-steroidal anti-inflammatory drugs

Aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) are often associated with peptic ulcer. A consecutive series of patients with rheumatic disease treated with NSAIDs entered a clinical trial after endoscopic diagnosis of gastric or duodenal ulcer. Three objectives were pursued: comparison between the healing capacities of sucralfate and ranitidine; evaluation of the influence of continuous NSAID administration during ulcer treatment; and determination of the peptic ulcer recurrence rate during a one-year follow-up. Average healing times were identical for 25 patients given sucralfate (4.6 weeks) and 27 patients given ranitidine (4.9 weeks). Ten patients with persistent ulcers after nine weeks of treatment received ulcer therapy for a further 3-9 weeks and healing was obtained in seven cases. Thirty patients continued on NSAID, and the ulcers healed in 23, whereas NSAID was withdrawn in 32 patients, of whom ulcer healing was documented in 29 (p greater than 0.10). 14 symptomatic recurrences were observed during the follow-up period. Adverse reactions were non-significant, and there were no cases of severe gastrointestinal bleeding.