[Effectiveness and safety of lansoprazole in the treatment of peptic ulcer].

BACKGROUND

Lansoprazole, a new proton pump inhibitor, is now available in Mexico. It has been tested elsewhere with excellent results.

OBJECTIVE

To study its safety and efficacy in Mexican patients.

METHODS

40 patients with gastric or duodenal ulcer larger than 0.5 cm, from 4 hospitals in central Mexico, were included. All were subjected to a complete medical history and upper GI endoscopy. symptoms (epigastric pain, heartburn, regurgitation, nausea, vomiting) were graded 1 to 4 according to severity. Lansoprazole (one 30 mg capsule/ day) was prescribed for 4 weeks in duodenal ulcer 8 weeks in gastric ulcer. Each patient was seen once a week at the office for compliance, symptom evaluation and side effects. A second endoscopy was performed at the end of the respective treatment period. Blood (CBC, chemistries) and urine tests were performed at the beginning and end of the study.

RESULTS

23 men and 17 women were included, Mean age: 53.8 yr. (19-95). 11 gastric ulcers and 29 duodenal ulcers. 27 measured 0.6-1.5 cm; 6 ulcers measured 1.6-2.5 cm; 6 ulcers were larger than 2.5 cm. 8 patients were bleeding at admission and 4 had multiple ulcers. 2 patients were lost to follow up. symptom grading: 18 patients had 10 points or less, 21 had more than 10 points, one bleeding patient was otherwise asymptomatic. After the first week of treatment, 42% were asymptomatic, after the 2nd. week, 75% were asymptomatic and 95% at the end of the study. The second endoscopy documented complete ulcer healing in 92% out of 37 remaining patients; further lansoprazole treatment healed 2 out of three unhealed ulcers. One patient underwent surgery for duodenal bulb stenosis. Side effects were reported by 2 patients. Treatment had to be discontinued in one patient because of headache. There was no effect of lansoprazole over the laboratory tests.

CONCLUSIONS

Lansoprazole was effective for prompt symptom relief in most patients and was able to heal more than 90% of gastric and duodenal ulcers with minimal side effects.