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The 24-hour intragastric pH of 12 patients with an acute duodenal ulcer was recorded with the aim of comparing the effects of two different times of administration of 300 mg ranitidine: post evening meal, or bedtime. This double-blind crossover trial involved 3 centres. Twenty-four-hour gastric pH was measured under standard conditions (meals, time schedule) at the middle of each 14-day treatment period. The analysis was performed on the percentage of times spent at pH levels below 1.5, 2, 3 and 4 for different periods and for the total 24 hours. During the whole day and night combined, as well as during the afternoon (12.00 hours-19.00 hours), there was no difference between the 2 regimens regardless of the pH profile studied. During the morning (07.30 hours-12.00 hours), the time spent below pH 1.5 and 2 was less when the drug was taken at bedtime (P less than 0.05). In contrast, during the whole night (19.00 hours-07.30 hours) the percentage of time spent below pH 1.5, 2 and 3 was significantly less when the drug was taken at post evening meal (P less than 0.05). These results show that in patients with acute duodenal ulcer, 300 mg ranitidine administered at the end of the evening meal provides better control of nocturnal acidity than administration at bedtime and hence is suggested for optimization of therapeutic efficacy.

This study was conducted to identify factors predicting favourable outcome after ranitidine 300 mg o.d. treatment for oesophagitis. Patients with grade 2 or 3 erosive oesophagitis were included in the study. Each investigator recruited 2 patients with the same grade of lesion in order to minimize bias in assessing symptoms. All patients received the same 6-week treatment: 300 mg ranitidine daily in the form of an effervescent tablet after the dinner. Symptomatology was assessed after 2 and 6 weeks of treatment and endoscopy was performed at the end of the treatment period. A successful outcome was defined as the absence of erosive lesions (grade 0 or 1). A total of 515 patients were recruited and 500 retained for analysis (15 patients did not follow the treatment protocol correctly): 267 grade 2 and 233 grade 3 (mean age: 52.5 years; sex ratio M/F: 1.7). Patients with grade 3 oesophagitis had more severe symptoms; hiatal hernia was also more frequent in this group. Alcohol intake and smoking habits were similar in both groups. After 6 weeks of treatment, successful healing was observed in 87 percent of the grade 2 patients and in 72 percent of the grade 3 patients. Three factors predicting successful outcome were found: grade 2 (odds ratio (OR): 1.50; p = 0.001), symptom duration less than 30 days after treatment onset (OR: 1.50; p = 0.001) and complete relief of symptoms after two weeks of treatment (OR: 1.31; p = 0.03). Disease history and the course of symptoms during treatment with ranitidine could help predict endoscopic outcome of oesophagitis.

This 1-year study compared two pragmatic strategies in long-term management of duodenal ulcer: continuous treatment with ranitidine 150 mg after dinner and treatment of duodenal ulcer attacks with ranitidine 300 mg and placebo in the interval. A multicentric, randomized double-blind study was conducted in 399 patients, 197 in the ranitidine group and 202 in the placebo group. Efficacy was judged by the prevalence of ulcer-pain recurrences; secondary criteria were the prevalence of endoscopic recurrences, complications and the number of facultative visits, hospitalizations and days off work related to duodenal ulcer disease. Both groups were similar with regard to main epidemiologic features and number of drop-outs (10.5 percent). Fifty-two patients were withdrawn for symptomatic or endoscopic relapses: 6 in the ranitidine group, 46 in the placebo group (p less than 0.05). Sixty-six percent of the patients remained asymptomatic at one year in the ranitidine group versus 33 percent in the placebo group (p less than 0.001). Seventeen patients with ranitidine (8.6 percent) and 59 with placebo (29.2 percent) experienced at least one endoscopic recurrence (p less than 0.05). In the placebo group, 8 complications were observed (bleeding = 5, duodenal stenosis = 3), and none in the ranitidine group (p less than 0.005). Patients with ranitidine had significantly less facultative visits and endoscopies, number of days off work, and hospitalizations (p less than 0.05). Tolerance was good (5 percent side-effects, all minor) and identical in the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Recent studies have shown that a single dose of ranitidine given for 2 weeks at 6 p.m. resulted in a higher healing rate of duodenal ulcer than the same dose given at 10 p.m. Our study was designed to confirm these results in a large population in France. Three hundred and fifty patients with endoscopically proven duodenal ulcer were randomly assigned to open treatment with ranitidine 300 mg, immediately after dinner (dinner group), or at bedtime (bedtime group). Endoscopy was performed after 2 and 4 weeks. Forty six patients were excluded from analysis (default: 3, date of endoscopies not respected: 43). Of the 304 patients analysed (mean age: 45.5 years, sex ration M/F: 3.2), 146 received ranitidine after dinner, 158 at bedtime. Age, sex, ethnic groups, smoking habits and alcohol consumption were comparable in the two groups. At endoscopy, before treatment, the mean diameter of ulcers was greater in the bedtime group than in the dinner group (bedtime: 9.6 mm, dinner: 7.9 mm). Healing rates after 2 weeks were 58 p. 100 in the dinner group and 40 p. 100 in the bedtime group (p = 0.002). After 4 weeks treatment, cumulative healing rates were 87.5 p. 100 and 83.5 p. 100, respectively. Smoking had an influence on healing after 2 weeks but not after 4 weeks of treatment. In conclusion, a single dose of 300 mg of ranitidine resulted in a higher healing rate of duodenal ulcer when given immediately after dinner than when given at bedtime.

The aim of this study was to evaluate, on a wide population of outpatients, the efficacy of ranitidine 300 mg given once a day at bedtime in duodenal and gastric ulcer. Healing rates observed on 1,208 patients were 85.2% (703/825) in duodenal ulcer, 79.5% (268/337) in gastric ulcer and 71.7% (33/46) in double localization, duodenal and gastric. Analysis of predictive factors of treatment failure showed no influence of smoking on the efficacy of ranitidine neither in duodenal nor gastric ulcer.

The aim of this study was to describe the clinical and endoscopic signs, the nutritional status, the consumption of alcohol and tobacco, and other associated factors in a population of 1,800 patients with endoscopically proven gastric (n = 501) or duodenal ulcer (n = 1235) and then to identify the risk factors in comparison to the French population. Patients with gastric ulcer were older, more often widowed if male, otherwise more often female, were more frequently treated by non-steroid drugs, and had a lipid-rich nutrition more often in comparison to patients with duodenal ulcers. Patients with duodenal ulcer were more often native from the Magreb and their nutrition was more often rich in spices in comparison to patients with gastric ulcer. The associations between use of non-steroidal drugs and consumption of spices disappeared after adjustment by multidimensional analysis. Patients with duodenal ulcer lived more frequently in the Ile de France area in comparison to patients with gastric ulcer. Patients with gastric ulcer worked more often as farmers in comparison to patients with duodenal ulcer and in comparison to the total French population. These differences remained after adjustment. The consumption of tobacco was higher in patients with gastric or duodenal ulcer in comparison to the mean consumption of the total French population.