Linked Life Data

1673953

Source:http://linkedlifedata.com/resource/pubmed/id/1673953

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
4
pubmed:dateCreated
1991-6-12
pubmed:abstractText
We tested the hypothesis that the gastric H+/K+ adenosine triphosphatase inhibitor, omeprazole, because of its different mode of action and pronounced inhibitory effect on gastric acid secretion, may be more effective in peptic ulcer that is refractory to histamine H2 receptor antagonist treatment than continuing the same therapy. Altogether 107 patients (duodenal ulcer, n = 88; prepyloric ulcer, n = 14; gastric ulcer, n = 3; mixed sites, n = 2) with refractory peptic ulcer - that is ulcer unhealed after at least two months' treatment with cimetidine 0.8 g or 1 g daily or with ranitidine 0.3 g daily - were randomly allocated to receive either omeprazole 40 mg daily (n = 54) or to continue treatment with the same H2 receptor antagonist and at the same dose (n = 53) for up to eight weeks. The patients in the two treatment groups were well matched demographically. Healing by 'intent to treat' analysis was as follows: at four weeks, omeprazole 46 of 54 (85%), H2 receptor antagonist 18 of 53 (34%) (p less than 0.0001); and at eight weeks, 52 of 54 (96%) and 30 of 53 (57%) respectively (p less than 0.0001). One patient was lost to follow up but of the 22 patients whose ulcers were shown to be unhealed at endoscopy after receiving continued H2 receptor antagonist treatment, 21 healed in four to eight weeks when changed to omeprazole. Daytime epigastric pain cleared at four weeks in 43 of 47 (91%) patients on omeprazole and in 32 of 46 (70%) on H2 receptor antagonists (p=0.01) and relief of all dyspeptic symptoms occurred in 39 of 47 (83%) and 23 of 45 (51%) (p=0.0009) patients respectively. Adverse events occurred in 11 of 54 (20%) patients on omeprazole and in 12 of 35 (34%) on cimetidine but in none on ranitidine. The events were mild and none required treatment withdrawal. The commonest event in patients on omeprazole was loose stools or diarrhoea (n=5). Omeprazole was significantly better than continued H2 receptor antagonist treatment for the short term management of refractory peptic ulcer as judged by healing rate and pain relief, and it was safe.
pubmed:commentsCorrections
http://linkedlifedata.com/resource/pubmed/commentcorrection/1673953-1624176, http://linkedlifedata.com/resource/pubmed/commentcorrection/1673953-2680793, http://linkedlifedata.com/resource/pubmed/commentcorrection/1673953-2908747, http://linkedlifedata.com/resource/pubmed/commentcorrection/1673953-2914544, http://linkedlifedata.com/resource/pubmed/commentcorrection/1673953-2979226, http://linkedlifedata.com/resource/pubmed/commentcorrection/1673953-3308650, http://linkedlifedata.com/resource/pubmed/commentcorrection/1673953-3314488, http://linkedlifedata.com/resource/pubmed/commentcorrection/1673953-3322955, http://linkedlifedata.com/resource/pubmed/commentcorrection/1673953-3410170, http://linkedlifedata.com/resource/pubmed/commentcorrection/1673953-3839484, http://linkedlifedata.com/resource/pubmed/commentcorrection/1673953-3884426, http://linkedlifedata.com/resource/pubmed/commentcorrection/1673953-6150884, http://linkedlifedata.com/resource/pubmed/commentcorrection/1673953-6376292, http://linkedlifedata.com/resource/pubmed/commentcorrection/1673953-6428982, http://linkedlifedata.com/resource/pubmed/commentcorrection/1673953-6469081, http://linkedlifedata.com/resource/pubmed/commentcorrection/1673953-6531660
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Apr
pubmed:issn
0017-5749
pubmed:author
pubmed:issnType
Print
pubmed:volume
32
pubmed:owner
NLM
pubmed:authorsComplete
N
pubmed:pagination
435-8
pubmed:dateRevised
2009-11-18
pubmed:meshHeading
pubmed:year
1991
pubmed:articleTitle
Treatment of refractory peptic ulcer with omeprazole or continued H2 receptor antagonists: a controlled clinical trial.
pubmed:affiliation
District General Hospital, Rotherham, UK.
pubmed:publicationType
Journal Article, Clinical Trial, Randomized Controlled Trial, Multicenter Study