Tildesley and colleagues conducted a study to evaluate the effect of 4 weeks of treatment with ranitidine 150 mg twice a day on healing of symptomatic gastric and duodenal ulcers and upper gastrointestinal lesions associated with nonsteroidal anti-inflammatory drug (NSAID) use in arthritic patients. The study also looked at the effect of withdrawal of NSAID therapy on the healing rate.

A total of 243 arthritic patients were randomized to one of the three treatment groups - ranitidine with continuation of NSAID (n=99), ranitidine with NSAID discontinued (n=94), and placebo with NSAID discontinued (n=50). This included 149 patients with peptic ulcers.

• After 4 weeks of treatment, gastric ulcers had healed in 67%, 68% and 47% of the patients in the three treatment groups, respectively.
• Duodenal ulcers healed in 61%, 81% and 42% of the patients, respectively.
• The difference between duodenal ulcer healing rates for ranitidine with NSAID discontinued and placebo was statistically significant (P=0.02).
• Healing rates were not affected by gender, age, smoking habits, alcohol consumption, ulcer frequency or size, arthritic disease, or participating country.
• Epigastric pain was reported by 88% of the gastric and duodenal ulcer patients at study entry. It was reported as moderate or severe by 73% and 78%, respectively. After 4 weeks of treatment, moderate or severe pain was reported by only 18% and 27% of patients, respectively.

Ranitidine 150 mg twice a day for 4 weeks effectively and safely healed gastric and duodenal ulcers in arthritic patients, whether or not the NSAID was continued.

Discontinuation of NSAIDs led to higher frequency of healing in patients with duodenal ulcers.

Source: Tildesley G, Ehsanullah RSB, Wood JR. Ranitidine in the treatment of gastric and duodenal ulcers associated with non-steroidal anti-inflammatory drugs. Br J Rheumatol. 1993;32:474-478.