Short-term treatment of duodenal ulcer with a single nocturnal dose of ranitidine: an up-to-date overview of Italian experience.

The author compares the efficacy of ranitidine 300 mg in a single bedtime dose, and ranitidine 150 mg twice daily, in 509 duodenal ulcer patients treated in two Italian multicentre trials. In the first of these trials the treatment period was 4 weeks plus a further 4 weeks in patients whose ulcers failed to heal, as against 2 plus 4 weeks in the other trial. Given the homogeneity of the patient entry and exclusion criteria, and the fact that identical clinical and endoscopic evaluation criteria were used in the two trials, the results are grouped together for analysis purposes. This permits detailed evaluation of the therapeutic effects of the two ranitidine regimens at two-weekly intervals over a total period of 8 weeks. With the single bedtime dose regimen, healing rates were 47.2% after 2 weeks, 81.7% after 4 weeks, 83.6% after 6 weeks and 94.8% after 8 weeks, while the corresponding rates for the twice-daily regimen were substantially similar (51.9%, 84.1%, 89.5% and 95.8%). The two regimens also produced comparable results in terms of relief of daytime and nocturnal ulcer pain. The Italian experience confirms, in a fairly large patient population, that the simpler ranitidine regimen represented by the single bedtime dose fully preserves its therapeutic efficacy in duodenal ulcer. Moreover, the fact that no differences were noted in responses of patients from the various different regions of Italy with their greatly differing constitutional, environmental and alimentary characteristics, appears to suggest that such factors are not sufficient in themselves to affect the therapeutic results obtained with the drug.