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1.
Aliment Pharmacol Ther ; 14(7): 911-8, 2000 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-10886047

RESUMO

BACKGROUND: Many individuals with heartburn self-medicate with antacids for relief of their symptoms. AIM: To compare efficacy of effervescent ranitidine to as-needed calcium carbonate antacids in subjects who self-treat heartburn. METHODS: A total of 155 subjects with frequent antacid-responsive heartburn were randomized to receive effervescent ranitidine 150 mg tablets b.d., or as-needed calcium carbonate 750 mg for 12 weeks. Endoscopic oesophagitis severity and mucosal histology were assessed at baseline, and at weeks 6 and 12. Heartburn frequency, severity, and antacid consumption were recorded daily, and quality of life was assessed at baseline, and at weeks 6 and 12. RESULTS: Heartburn frequency and severity were significantly decreased after 1 day of ranitidine (P < 0.02). By week 6, ranitidine had significantly decreased rescue antacid consumption (7.3 tablets, P < 0.001) vs. antacids (14.1 tablets). Endoscopic oesophagitis healing (

Assuntos
Azia/tratamento farmacológico , Ranitidina/uso terapêutico , Adulto , Idoso , Antiulcerosos/efeitos adversos , Antiulcerosos/uso terapêutico , Esôfago de Barrett/tratamento farmacológico , Carbonato de Cálcio/efeitos adversos , Carbonato de Cálcio/uso terapêutico , Método Duplo-Cego , Esofagite/tratamento farmacológico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ranitidina/efeitos adversos , Autoadministração , Resultado do Tratamento
2.
Gastroenterology ; 117(3): 527-35, 1999 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-10464128

RESUMO

BACKGROUND & AIMS: Azathioprine is effective for Crohn's disease but acts slowly. A loading dose may decrease the time to response. METHODS: A placebo-controlled study was conducted in patients with active Crohn's disease despite prednisone treatment. Patients were randomized to a 36-hour infusion of azathioprine, 40 mg/kg (51 patients), or placebo (45 patients) followed by oral azathioprine, 2 mg/kg, for 16 weeks. Prednisone was tapered over 5 weeks. The primary outcome measure was complete remission at week 8, defined by discontinuation of prednisone and a Crohn's Disease Activity Index of

Assuntos
Azatioprina/administração & dosagem , Doença de Crohn/tratamento farmacológico , Imunossupressores/administração & dosagem , Administração Oral , Adulto , Azatioprina/uso terapêutico , Doença de Crohn/sangue , Relação Dose-Resposta a Droga , Método Duplo-Cego , Eritrócitos , Feminino , Glucocorticoides/uso terapêutico , Humanos , Imunossupressores/uso terapêutico , Infusões Intravenosas , Contagem de Leucócitos , Masculino , Metiltransferases/sangue , Pessoa de Meia-Idade , Prednisona/uso terapêutico , Indução de Remissão , Tioguanina/sangue
3.
Arch Intern Med ; 158(21): 2373-6, 1998 Nov 23.
Artigo em Inglês | MEDLINE | ID: mdl-9827789

RESUMO

BACKGROUND: Many otherwise healthy individuals with episodic heartburn self-medicate with over-the-counter antacids. We evaluated clinical characteristics of subjects who had never been medically diagnosed as having any upper gastrointestinal tract disorder and who used antacids for symptomatic relief of heartburn. SUBJECTS AND METHODS: Subjects with at least 3 months of frequent heartburn relieved by antacids, and with heartburn on at least 4 of 7 days during the week prior to study entry, had their medical history and gastrointestinal pathological characteristics recorded. Tests included esophagogastroduodenoscopy, esophageal motility and sensitivity studies, and 24-hour pH monitoring. RESULTS: Of 178 subjects screened, 13 were excluded on the basis of other gastrointestinal diseases at baseline, including diffuse esophageal spasm, peptic ulcer disease, dysplastic columnar metaplasia of the esophagus (Barrett's esophagus), and adenocarcinoma. Ten subjects were ineligible because of insufficient baseline heartburn. The remaining 155 eligible subjects had heartburn for an average of 11 years. Forty-seven percent had daily symptoms and 70% described heartburn severity as moderate, even though on endoscopy most (53%) had normal-appearing esophageal mucosa (grade 0 or 1). Esophageal acid sensitivity was present in 86% of subjects. Mean lower esophageal sphincter pressures and esophageal contractile amplitudes were at the lower limits of normal and total esophageal acid contact time was slightly increased. CONCLUSIONS: Chronic heartburn can reflect a wide range of diagnostic findings, including important underlying pathological features, and may warrant a full medical examination to detect such abnormal conditions and to permit selection of appropriate therapy.


Assuntos
Antiácidos/uso terapêutico , Azia/tratamento farmacológico , Adenocarcinoma/diagnóstico , Adulto , Antiácidos/administração & dosagem , Esôfago de Barrett/diagnóstico , Diagnóstico Diferencial , Endoscopia do Sistema Digestório , Neoplasias Esofágicas/diagnóstico , Espasmo Esofágico Difuso/diagnóstico , Junção Esofagogástrica/fisiopatologia , Esôfago/fisiopatologia , Refluxo Gastroesofágico/diagnóstico , Azia/diagnóstico , Azia/fisiopatologia , Humanos , Concentração de Íons de Hidrogênio , Anamnese , Mucosa/fisiopatologia , Contração Muscular/fisiologia , Medicamentos sem Prescrição/uso terapêutico , Úlcera Péptica/diagnóstico , Peristaltismo/fisiologia , Exame Físico , Pressão , Automedicação , Sensação/fisiologia , Índice de Gravidade de Doença
4.
Clin Ther ; 18(6): 1175-83, 1996.
Artigo em Inglês | MEDLINE | ID: mdl-9001834

RESUMO

As many as 89% of gastric ulcer patients experience ulcer recurrences within 1 year of successful healing with conventional antiulcer therapies. Because ranitidine is effective in the healing of gastric and duodenal ulcers and the maintenance of healed duodenal ulcers, we hypothesized that ranitidine would also be effective in the maintenance of healed gastric ulcers. A 48-week, placebo-controlled, randomized, double-blind, multicenter trial was conducted to compare ranitidine 150 mg administered at bedtime with placebo for the maintenance of healed gastric ulcers. Endoscopies were performed at baseline and repeated after 12, 24, 36, and 48 weeks of treatment. Gastric ulcer recurrence rates at each scheduled endoscopy were significantly lower in patients receiving ranitidine (5%, 13%, 16%, and 19%, respectively) compared with those receiving placebo (20%, 30%, 40%, and 50%, respectively). Compared with placebo, ranitidine was more effective in maintaining healed gastric ulcers regardless of previous gastric ulcer history, smoking status, age (< 65 vs > or = 65 years), or sex. There were no significant differences between the two treatment groups in the number of patients experiencing adverse events or laboratory abnormalities. Ranitidine 150 mg administered at bedtime provides safe and effective treatment for the maintenance of healed gastric ulcers.


Assuntos
Antiulcerosos/uso terapêutico , Ranitidina/uso terapêutico , Úlcera Gástrica/prevenção & controle , Administração Oral , Adolescente , Adulto , Idoso , Antiulcerosos/efeitos adversos , Repouso em Cama , Relação Dose-Resposta a Droga , Método Duplo-Cego , Esquema de Medicação , Feminino , Seguimentos , Gastroscopia , Humanos , Masculino , Pessoa de Meia-Idade , Ranitidina/efeitos adversos , Recidiva , Análise de Regressão , Segurança , Úlcera Gástrica/patologia , Resultado do Tratamento
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