Pantoprazole versus omeprazole in the treatment of acute gastric ulcers

SUMMARY Background : Pantoprazole is a new substituted benzimidazole which is a potent inhibitor of gastric acid secretion by its action upon H + ,K + ‐ATPase. Methods : The proton pump inhibitors pantoprazole and omeprazole were compared in a randomized, doubleblind study in 219 patients with benign gastric ulcers. Patients received either pantoprazole 40 mg ( n = 146) or omeprazole 20 mg ( n = 73), once daily before breakfast for 4 weeks. Treatment was extended for a further 4 weeks if the ulcer had not healed. Results : After 4 weeks, complete ulcer healing was seen in 88% of protocol‐correct patients given pantoprazole and in 77% given omeprazole (between‐group difference P < 0.05). At 8 weeks, the corresponding values were 97% and 96% (not significant). In the comparative intention‐to‐treat analysis there were no statistical differences between the treatment groups. Among the patients who had ulcer pain prior to treatment, 79% of the pantoprazole group and 68% of the omeprazole group were pain‐free after 2 weeks, and after 4 weeks 88% and 81%, respectively (not significant). Pronounced improvement in the other gastrointestinal symptoms was seen in both groups. Only 10% of patients in each group reported adverse events. There were moderate increases in fasting serum gastrin levels with both treatments at 4 and 8 weeks. Conclusion : Pantoprazole, 40 mg once daily in the morning, is a highly effective, well tolerated treatment for acute, benign gastric ulcer. Pantoprazole and omeprazole were equally safe in the therapy of gastric ulcer.