PROGNOSTIC FACTORS FOR DUODENAL-ULCERS HE ALING - A RANITIDINE VERSUSOMEPRAZOLE CONTROLLED TRIAL

Objectives: The treatment of duodenal ulcers has changed greatly since the introduction of anti-H2 drugs and sodium pump inhibitors. However the effect of several factors influencing prognosis and the rate of h ealing remain to be elucidated. Methods: Five hundred forty five patie nts with a fibroscopically proven duodenal ulcer were included in a ra ndomized controlled trial and were treated far one month with omeprazo le (20 mg) or ranitidine (300 mg). Twenty epidemiological, clinical an d fibroscopic factors of prognosis were recorded when the patients ent ered in the study and were analyzed after the treatment period. Result s: Endoscopic healing was obtained in 90% of the omeprazole treated pa tients and in 78% of the ranitidine group (p < 0.001). Multifactorial analysis of the 20 prognostic factors showed that, excepting the treat ment factor, only the size of the ulcer (less than 11 mm), its shape ( round), its localisation (not on the posterior side) and a moderate pa in were factors of good prognosis. Paradoxically, in our study, male p atients and alcohol consumption were also positive factors of prognosi s. Conclusion: The probability of healing is best for round, small duo denal ulcers located on the anterior side of the bulb.