H2-blockers in the treatment of ulcer disease in the elderly

The efficacy and safety of therapy with H2-blockers in the elderly were assessed in a prospective, randomized, open study of 51 consecutive ulcer patients. All subjects were over 65 years of age and had active disease (endoscopically diagnosed). Twenty-three patients were assigned to famotidine 40 mg and 28 to raniridine 300 mg. Both agents were administered at night for 6 weeks in the acute phase of the trial. In the long-term evaluation, 27 patients received therapy at half the previous dosage for 6 months. Endoscopic evaluation were scheduled at the 6th week, 6th month, and at every symptomatic relapse. Clinical evaluations were repeated at the 3rd and 6th week and at the 3rd and 6th months. Routine laboratory tests were performed at the beginning of the study and at the end of the short- and long-term phases. Overall, elderly patients in our sample smoked fewer cigarettes and drank less alcohol than has been reported for the entire ulcer population. Ulcer syptoms, present in the active phase in 31 of 51 patients, disappered with treatment. Both famotidine and ranitidine were comparable in efficacy and safety; 5 patients had not healed at the end of short-term therapy (3 with famotidine and 2 with ranitidine therapy), and 1 relapsed during the long-term follow-up. No patient had ulcer symptoms after treatment, however, and no significant laboratory test alterations were found. We concludse that both famotidine and ranitidine are effective and safe in treatment of ulcer disease in the elderly.