AN OPEN TRIAL OF LONG-TERM THERAPY WITH LANSOPRAZOLE IN PATIENTS WITHPEPTIC-ULCERATION RESISTANT TO EXTENDED HIGH-DOSE RANITIDINE TREATMENT

Forty-two patients with peptic ulceration of the duodenum, stomach or oesophagus, who had not responded to 3 or more months of high-dose tre atment with ranitidine (450 or 600 mg/day), were treated with oral lan soprazole at 30-60 mg daily. In 40 patients (95.2%) the ulcers healed within 2-12 weeks. In the remaining 2 patients healing took several mo nths but eventually all ulcers healed. After healing, 40 patients unde rwent long-term maintenance treatment with 30-60 mg lansoprazole daily for 1-3 years (continuing). During maintenance therapy with lansopraz ole, no endoscopically verified relapses occurred when the drug was ta ken regularly. In 1 patient treatment had to be discontinued because o f a drug-related colitis that disappeared soon after treatment had bee n stopped. There were no significant changes in routine laboratory tes ts in any patient. Basal serum gastrin concentrations, which were alre ady elevated by the previous high-dose ranitidine treatment (125 +/- 2 5 pg/ml), rose to four times the normal values after 4 weeks of treatm ent with lansoprazole (255 +/- 65 pg/ml). Thereafter no further increa ses in basal serum gastrin concentrations were observed, even after 3 years of administration. The volume density of argyrophilic cells in t he oxyntic mucosa increased slightly during lansoprazole treatment; un til now no dysplasia of the enterochromaffin-like cells has been obser ved. In conclusion, 30-60 mg lansoprazole daily healed ranitidine-resi stant peptic ulcers, and subsequent maintenance therapy with 30-60 mg lansoprazole daily was found to be highly effective and safe over the time observed.