Efficacy and safety of lansoprazole in the treatment of gastric ulcer

Florent, C; Audigier, Jean-Christian; Boyer, J; Camatte, R; Corallo, Jacques; Delmont, J.; Doffoël, Michel; Escourrou, J.; Evreux, M; Gipoulou, Vincent; Laugier, R.; Paris, J; Pascal, Jean; Pienkowski, Pierre; Rampal, Patrick; Joubert-Collin, M.

doi:10.1097/00042737-199412000-00012

Cited by 9 publications

(9 citation statements)

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“…[3][4][5][6] However, comparative studies of ulcer recurrence rate between PPI-healed patients and H 2 RA-healed patients showed similar recurrence rates when maintenance therapy was not employed. 11,12 It seems to be difficult to change the natural history of ulcers, even when PPIs are used as the first-line therapy, and ulcer recurrence is still a major problem.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 PPIs have been reported to show good therapeutic results against acid-related diseases such as peptic ulcers and gastroesophageal reflux diseases. [3][4][5] In Japan, the evaluation of healing in peptic ulcer treatment is based on verification of S 1 -stage or S 2 -stage scars, determined according to the classification of Sakita and Miwa (see Table 1), 6 and many drugs are evaluated using this index. Ideally, healing should be evaluated by the S 2 -stage scar, because S 1 -stage scars with residual redness have been reported to show a higher recurrence rate than S 2 -stage scars with no redness.…”

Section: Introductionmentioning

confidence: 99%

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Peptic ulcer recurrence during maintenance therapy with H 2 -receptor antagonist following first-line therapy with proton pump inhibitor

Kaneko

Hoshihara

Sakaki

et al. 2000

Journal of Gastroenterology

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We investigated the peptic ulcer recurrence rates during maintenance therapy with H2-receptor antagonists (H2RAs) following first-line therapy with a proton pump inhibitor (PPI). Patients with gastric ulcer (GU) or duodenal ulcer (DU) were enrolled in this study; 583 eligible patients (GU, 325; DU, 258) were administered lansoprazole (30 mg/day for 8 weeks for GU, and the same dosage for 6 weeks for DU) as first-line therapy, and a half dose of H2RA as maintenance therapy for 12 months. Endoscopic photographs were taken before administration and after 8 (GU) and 6 (DU) weeks of lansoprazole administration. Ulcer stage was evaluated using the classification of Sakita and Miwa. Endoscopic examinations were performed 6 months or 12 months after the start of maintenance therapy or when a recurrence was suspected because of the appearance of subjective symptoms. The healing rates for GU and DU patients after completion of lansoprazole therapy were 79% in both groups, while the S2-stage healing rates were 18% and 31%, respectively. At 1 year after the start of maintenance therapy, the recurrence rates were 25% for GU and 39% for DU patients. In DU patients, the recurrence rates from S1-stage and S2-stage were 49% and 20%, respectively (P = 0.004), but no significant difference was found between these rates in GU patients. The recurrence rates in H. pylori-positive patients before lansoprazole administration were 27% for GU and 43% for DU patients. We concluded that the maintenance therapy with a half-dose of H2RA following PPI therapy was insufficient to prevent recurrences of GU and DU.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Peptic ulcer recurrence during maintenance therapy with H 2 -receptor antagonist following first-line therapy with proton pump inhibitor

Kaneko

Hoshihara

Sakaki

et al. 2000

Journal of Gastroenterology

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“…The studies comparing the efficacy of proton pump inhibitors for the treatment of peptic ulcer disease are summarized in Table 6. There have been at least three studies comparing different proton pump inhibitors for gastric ulcer healing 79 –81 . Rates of ulcer healing were significantly greater with lansoprazole 30 mg than omeprazole 20 mg, on an intention‐to‐treat analysis at 8 weeks ( P =0.04), and a trend favoured lansoprazole treatment at 4 weeks ( P = 0.06) 79 .…”

Section: Efficacymentioning

confidence: 99%

“…There have been at least three studies comparing different proton pump inhibitors for gastric ulcer healing 79 –81 . Rates of ulcer healing were significantly greater with lansoprazole 30 mg than omeprazole 20 mg, on an intention‐to‐treat analysis at 8 weeks ( P =0.04), and a trend favoured lansoprazole treatment at 4 weeks ( P = 0.06) 79 . The time to relief of symptoms was shorter with lansoprazole (mean 6.6 days compared with 11 days) and the trend for the overall percentage of patients with symptom relief favoured lansoprazole.…”

Section: Efficacymentioning

confidence: 99%

Review article: comparison of the pharmacokinetics, acid suppression and efficacy of proton pump inhibitors

Stedman

Barclay

2000

Aliment Pharmacol Ther

290

228

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Proton pump inhibitors have dramatically influenced the management of acid‐peptic disorders in recent years. They all have a broadly similar mechanism of action and are extensively metabolized in the liver via cytochromes P450 2C19 and 3A4. There is some variation in their potential for drug interactions due to differences in enzyme inhibition. Relatively few serious adverse effects have been reported for the proton pump inhibitors. Comparative studies of acid suppression suggest that lansoprazole and pantoprazole have a potency similar to that of omeprazole on a mg for mg basis; however, rabeprazole may have a greater potency than omeprazole. Lansoprazole and rabeprazole display a more rapid onset of maximal acid suppression than the other proton pump inhibitors. Comparative studies using proton pump inhibitors for the treatment of reflux oesophagitis, duodenal ulcer healing and Helicobacter pylori eradication show little overall difference in outcome between the proton pump inhibitors when used in their standard doses. Lansoprazole and rabeprazole provide earlier and better symptom relief than the other proton pump inhibitors in some studies of peptic ulcer treatment. The few studies of gastric ulcer treatment suggest that there is an advantage in using the proton pump inhibitors that have a higher standard daily dose.

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“…We also found that, there is some evidence of an advantage to prescribing two of the newer PPIs (lansoprazole or pantoprazole) compared to omeprazole for gastric ulcer, since there was a 15% increase in healing rates at 4 weeks. In addition, the newer PPIs (rabeprazole, lansoprazole and pantoprazole) have all been show to produce superior improvement in clinical symptoms compared to omeprazole at both 2 and 4 weeks [24-26]. …”

Section: Discussionmentioning

confidence: 99%

Are proton pump inhibitors the first choice for acute treatment of gastric ulcers? A meta analysis of randomized clinical trials

Salas¹,

Ward²,

Jaime

2002

BMC Gastroenterol

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BackgroundGastric ulcers are a frequent problem in the United States. Proton pump inhibitors have been shown to increase healing rates and improve clinical symptoms. The objective of this study is to compare gastric ulcer healing rates for patients treated with a proton pump inhibitor (PPI) (omeprazole, rabeprazole, pantoprazole, or lansoprazole), an histamine 2- receptor antagonist (ranitidine) or placebo.MethodsA literature search was conducted to identify randomized, controlled clinical trials that included a PPI in at least one treatment arm and assessed the gastric ulcer healing rates endoscopically. The healing rates were estimated for each treatment at specific time points, and Rate Ratios (RR) and 95% confidence intervals (CI) were estimated for each trial.ResultsSixteen trials met the inclusion criteria: four compared a PPI versus placebo, nine compared a PPI versus ranitidine (no trials of rabeprazole versus ranitidine met the inclusion criteria), and three compared a newer PPI (lansoprazole, pantoprazole or rabeprazole) versus omeprazole. In relation to ranitidine, the pooled RR of PPIs (lansoprazole, omeprazole and pantoprazole) was 1.33 (95% CI 1.24 to 1.42) at four weeks. In each trial, greater improvement in the studied clinical symptoms was found with the newer PPIs (rabeprazole, pantoprazole and lansoprazole) when compared to omeprazole.ConclusionIn this study treatment with PPIs resulted in higher healing rates than ranitidine or placebo. This evidence suggests that the first choice for gastric ulcer treatment for the greater relief of symptoms is one of the newer PPIs.

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Efficacy and safety of lansoprazole in the treatment of gastric ulcer

Cited by 9 publications

References 0 publications

Peptic ulcer recurrence during maintenance therapy with H 2 -receptor antagonist following first-line therapy with proton pump inhibitor

Peptic ulcer recurrence during maintenance therapy with H 2 -receptor antagonist following first-line therapy with proton pump inhibitor

Review article: comparison of the pharmacokinetics, acid suppression and efficacy of proton pump inhibitors

Are proton pump inhibitors the first choice for acute treatment of gastric ulcers? A meta analysis of randomized clinical trials

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