5-YEAR MAINTENANCE TREATMENT WITH RANITIDINE - EFFECTS ON THE NATURAL-HISTORY OF DUODENAL-ULCER DISEASE

In this study, we assessed the effect of a 5-yr maintenance program wi th ranitidine on the natural history of duodenal ulcer disease both du ring treatment and after drug withdrawal. Two groups of patients with duodenal ulcer were studied. In group A patients (n=40), ranitidine (1 50 mg/day) was given continuously for 5 yr; group B patients (n=40), r eceived seasonal, 8-wk prophylactic treatment with ranitidine (300 mg/ day), in spring and fall. Routine endoscopy was performed every year a nd whenever ulcer symptoms recurred. After the 5-yr study, the drug wa s discontinued in both groups, and patients underwent endoscopy after 3, 6, 12, and 18 months. The probability of duodenal ulcer recurrence was significantly lower in patients continuously receiving ranitidine (p<0.001), and ulcer complications were significantly lesser in group A patients (p<0.03). In the 18 months of follow-up after drug disconti nuation, only 15% (4/26) of patients of group A relapsed, whereas ulce r recurrence was diagnosed in 84% (26/32) of group B patients (p<0.001 ). We conclude that low-dose continuous treatment with ranitidine is p referable to seasonal prophylaxis for its ability to modify the natura l history of duodenal ulcer disease.