A study was conducted to determine the efficacy of ranitidine in the treatment of non-steroidal anti-inflammatory drug (NSAID)-related dyspeptic symptoms, with and without peptic ulcer disease (PUD), in 124 patients with rheumatoid arthritis (RA) and osteoarthritis (OA). Patients continuing NSAID use were evaluated with gastroduodenoscopy.

Patients with PUD were given ranitidine 150 mg b.i.d. and those without PUD were randomized to ranitidine 150 mg b.i.d. or placebo for 4 weeks.

PUD was noted in 26% of consecutive patients who presented with dyspeptic symptoms. Among these patients, dyspeptic symptoms resolved in 8 (26%) of 31 evaluable patients and PUD was healed in 18 (56%) patients after 4 weeks of treatment. Following 8 weeks of treatment, PUD was healed in 27 (87%) patients.

Among the remaining patients without PUD, dyspeptic symptoms resolved in 24 (26%) of the patients treated with ranitidine, which was significantly better (p<0.02) than the 5 (6%) patients treated with placebo. The minor mucosal lesions seen in these patients showed similar improvement in the ranitidine and placebo groups. However, 1 placebo-treated patient worsened and 2 placebo-treated patients developed PUD during the 4 weeks of study.

Oral treatment with ranitidine 150 mg b.i.d. appears to be effective in the treatment of dyspeptic symptoms as well as mucosal lesions in RA and OA patients continuing the use of NSAIDs.

Source: van Groenendael JHLM, Markusse HM, Dijkmans BAC, Breedveld FC. The effect of ranitidine on NSAID related dyspeptic symptoms with and without peptic ulcer disease of patients with rheumatoid arthritis and osteoarthritis. Clin Rheumatol 1996;15:450–456.