[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.

Aim: To study its safety and efficacy in Mexican patients.

Method: 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.