Continuous therapy with low-dose ranitidine has been shown to be effective for the prevention of recurrent nonsteroidal anti-inflammatory drug (NSAID)-associated duodenal ulcer.

A study was conducted to assess the role of high dose of ranitidine (300 mg b.d.) in preventing the recurrence of duodenal and gastric ulcers in rheumatoid arthritis patients with a continuous requirement of NSAIDs.

This was a double-blind placebo-controlled study, in which patients with rheumatoid arthritis with a history of peptic ulcer disease were randomly allocated to receive either ranitidine 300 mg b.d. or placebo for a duration of12 months.

Endoscopy was performed at study initiation and after 6 and 12 months. The study end point was recurrence of gastric or duodenal ulcers.

The study was stopped following a blinded interim analysis. Ten of the 15 included patients in each treatment group were evaluable at that time.

• Recurrent duodenal ulcers were noted in four patients in the placebo group but in no patient in the ranitidine arm.
• Recurrent gastric ulcers occurred in six patients in the placebo group, compared to three patients in the ranitidine group.
• Two patients in the placebo group developed both duodenal ulcers and gastric ulcers.
• No adverse events were reported during the study.

To conclude, high dose ranitidine is an effective drug for the prevention of recurrent duodenal ulcers in rheumatoid arthritis patients on NSAID therapy.

Source: Wolde ST, Dijkmans BA, Janssen M, et al. High-dose ranitidine for the prevention of recurrent peptic ulcer disease in rheumatoid arthritis patients taking NSAIDs. Aliment Pharmacol Ther. 1996 Jun;10(3):347-51.