Non-steroidal anti-inflammatory drugs (NSAIDs) have been shown to result in gastric and duodenal damage in short-term studies involving normal individuals as well as in patients undergoing long-term treatment.

Swift et al conducted a double-blind placebo-controlled trial to determine the effects of ranitidine 300mg and 600mg on upper gastrointestinal mucosal damage in 24 patients receiving long-term NSAIDs. Patients were randomized to one of three groups: Groups A and B received ranitidine while group C received placebo. After an initial 7-day observation period, treatment was divided into two 7-day periods (Period I and II). Group A was given ranitidine 150mg twice a day in period II and 300mg twice daily in period III. Group B received the dosages in reverse order. Group C was divided into two. Sixteen patients received ranitidine and 8 received placebo.

• Ranitidine was found to reduce the symptoms and endoscopic evidence of mucosal damage.
• Histologic evidence of gastritis was evident in half of the patients treated with ranitidine, while it was noted in all patients given placebo.
• There was no significant change in fecal blood loss in treatment groups in comparison with placebo group.    

Ranitidine improves symptoms as well as endoscopic appearance of gastroduodenal mucosa in patients on NSAID therapy.

Endoscopic evaluation of erosions and serial biopsies may reliably assess the impact of treatment in reducing mucosal damage from long-term NSAID therapy.

Source: Swift GL, Heneghan M, Williams GT, et al. Effect of ranitidine on gastroduodenal mucosal damage in patients on long-term non-steroidal anti-inflammatory drugs. Digestion 1989;44:86-94.