Brief Article
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World J Gastroenterol. Nov 14, 2010; 16(42): 5342-5346
Published online Nov 14, 2010. doi: 10.3748/wjg.v16.i42.5342
Comparative study of therapeutic effects of PPI and H2RA on ulcers during continuous aspirin therapy
Hiroaki Nema, Mototsugu Kato
Hiroaki Nema, Department of Internal Medicine, Teishinkai Hospital, North 44, East 8, Higashi-ku, Sapporo, Hokkaido 007-0844, Japan
Mototsugu Kato, Division of Endoscopy, Hokkaido University Hospital, North 14, West 5, Kita-ku, Sapporo, Hokkaido 060-8468, Japan
Author contributions: Nema H and Kato M performed the majority of the experiments; Kato M designed the study; Nema H wrote the manuscript.
Correspondence to: Mototsugu Kato, MD, PhD, Division of Endoscopy, Hokkaido University Hospital, North 14, West 5, Kita-ku, Sapporo, Hokkaido 060-8468, Japan. m-kato@med.hokudai.ac.jp
Telephone: +81-11-7161161 Fax: +81-11-7067867
Received: April 20, 2010
Revised: June 9, 2010
Accepted: June 16, 2010
Published online: November 14, 2010
Abstract

AIM: To compare the therapeutic effects of proton pump inhibitors (PPI) and histamine 2 receptor antagonists (H2RA) on gastroduodenal ulcers under continuous use of low-dose aspirin.

METHODS: Sixty patients who had a gastroduodenal ulcer on screening endoscopy but required continuous use of low-dose aspirin were randomly assigned to receive PPI (lansoprazole 30 mg, n = 30) or H2RA (famotidine 40 mg or if famotidine had been administered before assignment, ranitidine 300 mg, n = 30). The therapeutic effects were evaluated by endoscopy after 8-wk treatment. The presence or absence of Helicobacter pylori (H. pylori) was determined by urea breath test before treatment. Abdominal symptoms were compared with the gastrointestinal symptom rating scale (GSRS) questionnaire before and after treatment.

RESULTS: Twenty-six patients in the PPI group and 26 patients in the H2RA group, excluding dropouts, were analyzed. There were no significant differences in median age, sex, underlying disease, smoking status, H. pylori infection, prevalence of ulcers before treatment, and lesion site between the two groups. The therapeutic effects were endoscopically evaluated as healed in 23 patients (88.5%) and not healed in 3 patients in the PPI group and as healed in 22 patients (84.6%) and not healed in 4 patients in the H2RA group. Abdominal symptoms before treatment were uncommon in both groups; the GSRS scores were not significantly reduced after treatment as compared with before treatment.

CONCLUSION: The healing rate of gastroduodenal ulcers during continuous use of low-dose aspirin was greater than 80% in both the PPI group and the H2RA group, with no significant difference between the two groups.

Keywords: Low-dose aspirin; Proton pump inhibitors; Histamine 2 receptor antagonists; Gastric ulcer