Carprofen and the therapy of gastroduodenal ulcerations by ranitidine

The effects of the addition of carprofen (Roche), a new nonsteroidal antiinflammatory agent, to regular 4-5 week ranitidine (300 mg/day) therapy on gastric secretion, serum gastrin level and ulcer healing, have been examined in 15 gastric ulcer (GU) and 60 duodenal ulcer (DU) patients. Carprofen at a therapeutic dose (300 mg/day) was well tolerated by both GU and DU patients and did not give rise to any major adverse effects. In an open trial on 15 GU (all receiving carprofen), complete endoscopic ulcer healing was found in 9 patients after 3 weeks and in 6 others after 5 weeks of treatment. In a double blind, placebo controlled trial on 60 DU (30 receiving carprofen and 30 receiving placebo), complete ulcer healing was seen after 2 weeks in 23 on carprofen and 22 on placebo, and after 4 weeks in all tested patients. Pentagastrin-induced maximal acid secretion examined 24 h after the last dose of treatment was significantly reduced in DU, but not in GU, patients, and was accompanied by a significant rise in plasma gastrin levels. No change in gastric histology was observed in any patient tested. This study provides evidence that carprofen added to antiulcer ranitidine therapy shows excellent gastrointestinal tolerance, and does not interfere with ulcer healing; it is, therefore, recommended in the treatment of arthritic patients with peptic ulcer disease.