Lansoprazole 30 mg daily versus ranitidine 150 mg b.d. in the treatment of acid‐related dyspepsia in general practice

Abstract

Aim: To compare lansoprazole 30 mg daily with ranitidine 150 mg b.d. in the treatment of acid‐related dyspepsia in general practice. Methods: In a double‐blind, parallel group, randomized, multicentre study conducted in 32 general practices in the UK, 213 patients were randomized to receive lansoprazole 30 mg daily, and 219 to receive ranitidine 150 mg b.d., for 4 weeks. All patients had experienced symptoms of reflux‐like or ulcer‐like dyspepsia on at least 4 of the 7 days prior to the study; 75% had experienced dyspepsia in the past, and 74 of the lansoprazole patients and 77 of the ranitidine patients had documented histories of acid‐related disorders, investigated by either radiology or endoscopy. Results: After 2 weeks 55% of the lansoprazole patients and 33% of the ranitidine group were symptom‐free (P = 0.001, χ2 = 7.12) with corresponding 4‐week figures of 69% and 44%, respectively (P = 0.001, χ2 = 18.03). Similar figures were found at both 2 and 4 weeks for daytime and night‐time heartburn and epigastric pain scores; in the lansoprazole group, at 4 weeks, 80% of patients were free of daytime heartburn and 81% of night‐time epigastric pain, compared with 55% (P = 0.001, χ2 = 15.44) and 65% (P = 0.01, χ2 = 6.10) in the ranitidine group. Conclusion: Superior symptom relief for patients presenting with ulcer‐like and reflux‐like symptoms in general practice is provided by lansoprazole 30 mg daily compared with ranitidine 150 mg twice daily.

Drug treatment of functional dyspepsia

“…After 2 wk 55% of the lansoprazole patients and 33% of the ranitidine group were symptom-free (P = 0.001) with corresponding 4-wk figures of 69% and 44%, respectively (P = 0.001). In the lansoprazole group, at 4 wk, 80% of patients were free of daytime heartburn and 81% of night-time epigastric pain, compared with 55% (P = 0.001) and 65% (P = 0.01) in the ranitidine group [25] . Peura et al [26] compared the efficacy of lansoprazole with placebo in relieving upper abdominal discomfort in 921 patients with functional dyspepsia in a blinded-randomized trial and moderate upper abdominal discomfort on at least 30% of screening days [26] .…”

“…Responders had fewer clinic visits than non-responders (1.5 vs 2.0 mean visits) and fewer days on medication (mean, 9 d vs 23 d) over the 3-mo period (both, P < 0.001). The quality of life in responders was better at study entry and persisted over 3 mo (all, P < 0.001) Two large studies using lansoprazole have been published [25][26] . Jones et al performed a double-blind, parallel group, randomized, multi-center study in 32 general practices in the UK [25] .…”

“…The quality of life in responders was better at study entry and persisted over 3 mo (all, P < 0.001) Two large studies using lansoprazole have been published [25][26] . Jones et al performed a double-blind, parallel group, randomized, multi-center study in 32 general practices in the UK [25] . The investigators randomized 213 patients with symptoms of reflux-like or ulcer-like dyspepsia to receive lansoprazole 30 mg daily, and 219 to receive ranitidine 150 mg b.i.d.…”

“…In most studies standard doses of H2-blockers were used but the duration of therapy was not longer than 8 wk [18] . Larger studies evaluating higher doses of H2-receptor antagonists and of longer duration may be necessary to determine the exact effect of H2-blockers on functional dyspepsia, but because PPI have been shown to be superior to placebo or H2-blockers in the therapy of functional dyspepsia, it is likely that we will not see major H2-blocker studies for the therapy of dyspepsia in the future [19][20][21][22][23][24][25][26][27] .…”

The management of dyspepsia: a systematic review.

“…All seven trials were RCTs, but only five 142,144,[146][147][148] reported their method of allocation, and only three of these 144,146,147 the mechanism of sequence generation. One study used a centralised telephone randomisation service.…”