Long-term therapy with pantoprazole in patients with peptic ulceration resistant to extended high-dose ranitidine treatment

Aliment Pharmacol Ther. 1994;8 Suppl 1:59-64. doi: 10.1111/j.1365-2036.1994.tb00259.x.


Patients (106) with peptic ulceration of the oesophagus, stomach and duodenum, unresponsive to 3 or more months of high-dose treatment with ranitidine, were initially given pantoprazole (40-80 mg, p.o.) daily. In 96.7% of the patients ulcers healed within 2 to 8 weeks, and in 2.3% of patients the ulcers healed within 12 weeks. In just one patient with severe oesophagitis, the lesion took more than 6 months to heal. After ulcer healing, patients (98 to date) were treated with pantoprazole (40 mg/day) as long-term maintenance therapy. Eighty-eight of the 98 patients have been taking pantoprazole for 6 months to 3 years. During maintenance therapy, peptic disease was kept in remission in most patients with 40 mg pantoprazole. Twelve patients with oesophagitis and two patients with gastric ulcers needed higher doses (80-120 mg) to control the disease. One female patient developed peripheral oedema which disappeared quickly after stopping treatment. No further drug-related adverse effects were observed. Seven patients withdrew from the study and two patients died, all for non-drug-related reasons. Routine laboratory tests remained without significant changes in all patients. Mean (+/- S.E.M.) serum gastrin levels were already elevated during the initial high-dose ranitidine treatment (128 +/- 23 pg/ml). Within one year of the start of the pantoprazole treatment, serum gastrin levels rose to 3 times normal values (189 +/- 32 pg/ml). Thereafter, no further increases in serum gastrin were observed for up to 2.5 years. Enterochromaffin-like (ECL) cell density increased very slightly from 0.19% to 0.24% within one year.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication types

  • Clinical Trial

MeSH terms

  • 2-Pyridinylmethylsulfinylbenzimidazoles
  • Benzimidazoles / adverse effects
  • Benzimidazoles / therapeutic use*
  • Duodenal Ulcer / drug therapy
  • Enterochromaffin Cells / drug effects
  • Esophagitis / drug therapy
  • Female
  • Gastrins / blood
  • Humans
  • Longitudinal Studies
  • Male
  • Omeprazole / analogs & derivatives
  • Pantoprazole
  • Peptic Ulcer / drug therapy*
  • Proton Pump Inhibitors*
  • Ranitidine / therapeutic use
  • Stomach Ulcer / drug therapy
  • Sulfoxides / adverse effects
  • Sulfoxides / therapeutic use*


  • 2-Pyridinylmethylsulfinylbenzimidazoles
  • Benzimidazoles
  • Gastrins
  • Proton Pump Inhibitors
  • Sulfoxides
  • Ranitidine
  • Pantoprazole
  • Omeprazole