Comparison of misoprostol and ranitidine in the treatment of duodenal ulcer.

The efficacy of misoprostol (a synthetic analogue of prostaglandin E1) and ranitidine in the treatment of duodenal ulcer was evaluated. Seventy-one patients with endoscopically proven duodenal ulcer were randomized in a double-blind manner in one of two groups that received two daily doses of 400 micrograms misoprostol or 150 mg ranitidine. Ulcer healing was assessed endoscopically after 4 weeks of treatment; in subjects who had not healed treatment was continued and endoscopy was repeated after another 4 weeks. The mean age, sex distribution and tobacco, alcohol and caffein consumption were similar in both groups. In the misoprostol-treated group, healing of the ulcer was observed in 74.8% of patients at 4 weeks and in 86.5% at 8 weeks; in the ranitidine group (n = 34), the healing rate was 91.2 and 100%, respectively. The differences between healing rates in the two groups were not statistically significant. In the misoprostol group (n = 37), 27% of patients experienced diarrhea; of these, two were withdrawn from the trial due to this side effect. These results, which are part of a multicenter international study, suggest that misoprostol at a daily dose of 800 micrograms is as effective as 300 mg/day ranitidine in the treatment of duodenal ulcer.