TRIPLE THERAPY WITH RANITIDINE OR LANSOPRAZOLE IN THE TREATMENT OF HELICOBACTER-PYLORI-ASSOCIATED DUODENAL-ULCER

(O)bjective: The aim of this study was to verify the efficacy-in the c ure of duodenal-ulcer associated H. pylori infection-of ranitidine 300 mg taken late in the evening or lansoprazole 30 mg taken before break fast, coupled with clarithromycin and metronidazole. Methods: Eighty p atients with endoscopically proven active duodenal ulcer were randomiz ed to take ranitidine or lansoprazole for 4-8 wk, together with clarit hromycin 250 mg b.i.d. and metronidazole 500 mg b.i.d. for the first 2 wk. Endoscopic controls, as well as histological and urease tests for H. pylori, were performed at entry and after 4 and 8 wk. Results: Acc ording to intent-to-treat analysis, ulcers were healed after 4 wk in 3 6/40 patients (90%) with ranitidine and in 38/40 (95%) with lansoprazo le. After 8 wk, the healing percentage with ranitidine and lansoprazol e was 97% (39/40) and 95% (38/40), respectively. H. pylori was eradica ted in 85% of the patients taking ranitidine and in 90% of those takin g lanzoprazole. Side effects were reported in 25% of the patients in b oth groups, Conclusions: Our results confirm that the combination of r anitidine, clarithromycin, and metronidazole can be considered an alte rnative to proton pump inhibitors in terms of clinical efficacy and ec onomy.