Ranitidine in duodenal ulcer: incidence of healing and effect of smoking

The effect of ranitidine, a new H2-receptor antagonist, on the healing of duodenal ulcer has been assessed in a double-blind study. Fifty patients with endoscopically proven duodenal ulcer were randomly assigned to ranitidine 150 mg twice daily or placebo for 4 weeks. Endoscopic examination at this time showed that 20 of 25 patients (80%) on ranitidine healed compared to 4 of 25 patients (16%) on placebo (P less than 0.01). Smoking adversely affected the incidence of healing: 70% of nonsmokers healed compared to 30% of smokers (P less than 0.03). There were no side effects noted on ranitidine. Review at 6 months after cessation of therapy showed relapse of duodenal ulcer in 10 of 20 patients (50%) healed with ranitidine and 1 of 4 patients (20%) healed with placebo. Thus, ranitidine (300 mg/day) produces similar healing rates to those reported for cimetidine (1000 mg/day); also like cimetidine, the incidence of healing on ranitidine is adversely influenced by smoking and the relapse rate on cessation of therapy is high.