The efficacy of the third pump inhibitor - pantoprazole - in the short-term treatment of Chinese patients with duodenal ulcer

BACKGROUND/AIMS: To study the efficacy and tolerability of pantoprazole 40m g once daily before breakfast compared with ranitidine 300mg once daily at bedtime in Chinese patients with duodenal ulcer, and to evaluate the relati onship between Helicobacter pylori (H. pylori) clearance and ulcer healing rate. METHODOLOGY: A total of 160 patients (80 in each group) with endoscopically diagnosed, active duodenal ulcers were studied in this randomized double-b lind trial. Endoscopy was performed after 2 weeks of treatment. If unhealed , then the patients were re-endoscoped after an additional 2 weeks of simil ar treatment. RESULTS: The healing rates after 2 and 4 weeks were 61.3% and 97.3%, respec tively in the pantoprazole group, and 50.7% and 76.9% in the ranitidine gro up. The difference between the two groups was significant at 4 weeks (p < 0 .01, per protocol analysis). The rate of pain free ulcer was higher in the pantoprazole group than in the ranitidine group at 2 weeks (84.2% vs. 59.6% , p < 0.01). Higher clearance of H. pylori was also observed in the pantopr azole group compared with the ranitidine group at 4 weeks (20% vs. 0%, p = 0.05). The healing rate tended to be higher in patients who were H. pylori- cleared at 2 weeks (p = 0.07) in the pantoprazole group. Both medications w ere well. tolerated without any serious adverse effects. CONCLUSIONS: Pantoprazole 40mg daily is superior to ranitidine 300mg daily in the short-term. treatment of acute duodenal ulcer in Chinese patients, i n terms of ulcer healing and pain relief, and appears to be well-tolerated.