gefarnate and Stomach-Ulcer

Topics: Aluminum; Antacids; Anti-Ulcer Agents; Benzimidazoles; Carbenoxolone; Domperidone; Gefarnate; Glycyrrhiza; Histamine H2 Antagonists; Humans; Metoclopramide; Microscopy, Electron, Scanning; Morpholines; Parasympatholytics; Piperidines; Plants, Medicinal; Proglumide; Stomach Ulcer; Sucralfate; Trimipramine

Topics: Amylopectin; Carbenoxolone; Cholestyramine Resin; Cimetidine; Gastrointestinal Agents; Gefarnate; Humans; Parasympatholytics; Stomach Ulcer; Trimipramine

Low-dose lansoprazole has not been intensively evaluated for its efficacy in the prevention of recurrent gastric or duodenal ulcers in patients receiving long-term non-steroidal anti-inflammatory drug (NSAID) therapy for pain relief in such diseases as rheumatoid arthritis, osteoarthritis, and low back pain.. This multi-center, prospective, double-blind, randomized, active-controlled study involving 99 sites in Japan was designed to compare the efficacy of lansoprazole (15 mg daily) with gefarnate (50 mg twice daily). Patients with a history of gastric or duodenal ulcers who required long-term NSAID therapy were randomized to receive lansoprazole 15 mg daily (n = 185) or gefarnate 50 mg twice daily (n = 181) and followed up for 12 months or longer prospectively.. The cumulative incidence of gastric or duodenal ulcer at days 91, 181, and 361 from the start of the study was calculated by the Kaplan-Meier method as 3.3, 5.9, and 12.7%, respectively, in the lansoprazole group versus 18.7, 28.5, and 36.9%, respectively, in the gefarnate group. The risk for ulcer development was significantly (log-rank test, P < 0.0001) lower in the lansoprazole group than in the gefarnate group, with the hazard ratio being 0.2510 (95% CI 0.1400-0.4499). A long-term follow-up study showed an acceptable safety profile for low-dose lansoprazole therapy, with diarrhea as the most frequent adverse event.. Lansoprazole was superior to gefarnate in reducing the risk of gastric or duodenal ulcer recurrence in patients with a definite history of gastric or duodenal ulcers who required long-term NSAID therapy.

Topics: 2-Pyridinylmethylsulfinylbenzimidazoles; Aged; Anti-Inflammatory Agents, Non-Steroidal; Anti-Ulcer Agents; Arthritis; Double-Blind Method; Duodenal Ulcer; Female; Gefarnate; Humans; Kaplan-Meier Estimate; Lansoprazole; Low Back Pain; Male; Middle Aged; Prospective Studies; Secondary Prevention; Stomach Ulcer; Treatment Outcome

The efficacy of low-dose lansoprazole has not been established for the prevention of recurrent gastric or duodenal ulcers in those receiving long-term low-dose aspirin (LDA) for cardiovascular and cerebrovascular protection. This study sought to examine the efficacy of low-dose lansoprazole (15 mg once daily) for the secondary prevention of LDA-associated gastric or duodenal ulcers.. Patients were randomized to receive lansoprazole 15 mg daily (n = 226) or gefarnate 50 mg twice daily (n = 235) for 12 months or longer in a prospective, multicenter, double-blind, randomized active-controlled trial, followed by a 6-month follow-up study with open-label lansoprazole treatment. The study utilized 94 sites in Japan and 461 Japanese patients with a history of gastric or duodenal ulcers who required long-term LDA therapy for cardiovascular and cerebrovascular disease.. The primary endpoint was the development of gastric or duodenal ulcers. The cumulative incidence of gastric or duodenal ulcers on days 91, 181, and 361 from the start of the study was calculated by the Kaplan-Meier method as 1.5, 2.1, and 3.7%, respectively, in the lansoprazole group versus 15.2, 24.0, and 31.7%, respectively, in the gefarnate group. The risk of ulcer development was significantly (log-rank test, P < 0.001) lower in the lansoprazole group than in the gefarnate group, with the hazard ratio being 0.099 (95% confidence interval [CI] 0.042-0.230).. Lansoprazole was superior to gefarnate in reducing the risk of gastric or duodenal ulcer recurrence in patients with a definite history of gastric or duodenal ulcers who required long-term LDA therapy.

Topics: 2-Pyridinylmethylsulfinylbenzimidazoles; Aged; Anti-Ulcer Agents; Aspirin; Double-Blind Method; Duodenal Ulcer; Female; Follow-Up Studies; Gefarnate; Humans; Incidence; Japan; Kaplan-Meier Estimate; Lansoprazole; Male; Middle Aged; Platelet Aggregation Inhibitors; Prospective Studies; Secondary Prevention; Stomach Ulcer

The new H2 receptor antagonist, famotidine, has been tested in open and double-blind studies in over 2,000 acute duodenal or gastric ulcer patients as well as in the maintenance of chronic duodenal ulcer patients. In early studies, dosages of 20 mg b.i.d. were found to achieve better results than 10 mg b.i.d. and equivalent to 20 mg t.i.d. Trials comparing famotidine to cimetidine, ranitidine, and gefarnate found the new agent to be approximately equivalent to cimetidine and ranitidine and superior to gefarnate in the treatment of acute duodenal ulcer. Similar trials were conducted to compare different types of therapy in acute gastric ulcer. Famotidine 40 mg at bedtime was significantly more effective than placebo, and a 20 mg b.i.d. dosage once again proved at least as active as cimetidine 200 mg q.i.d. and considerably more effective than gefarnate. Furthermore, famotidine 20 mg at bedtime was found to effectively prevent relapses for at least 6 months. The side effect profile was extremely favorable--adverse reactions were rare and never positively associated with the drug. Although experience with this new agent is still somewhat limited, preliminary results indicate that famotidine is at least comparable with the other available H2 antagonists and can be considered an excellent choice for treatment of peptic ulcer disease.

Topics: Acute Disease; Chronic Disease; Cimetidine; Circadian Rhythm; Clinical Trials as Topic; Double-Blind Method; Drug Administration Schedule; Duodenal Ulcer; Endoscopy; Famotidine; Gefarnate; Histamine H2 Antagonists; Humans; Ranitidine; Stomach Ulcer; Thiazoles; Time Factors

We assessed the effects of some gefarnate analogs on gastric ulcer prophylaxis (adrenaline ulcers) and ulcer healing (acetic ulcers) and some secretory parameters in rats. Acute ulcers were induced in male Wistar rats by intraperitoneal injection of 2 mg/kg adrenaline hydrochloride. Rats were killed after 24 hours. Chronic gastric ulcers were induced in rats by application of 100% acetic acid to the serosal surface of the stomach on 60 sec. Gefarnate analogs introduced intraperitoneally or intragastrically. Gefarnate analogs dose-dependently increase the healing of gastric ulcers and have a marked prophylaxis effects especially in the case of adrenaline ulcers.

Topics: Animals; Anti-Ulcer Agents; Disease Models, Animal; Gastric Mucosa; Gefarnate; Male; Molecular Structure; Oxygen; Rats; Stomach Ulcer; Treatment Outcome; Wound Healing

We observed the quantitative estimation of the transmural changes associated with gastric ulcer healing by using endoscopic ultrasonography (EUS). It was possible to diagnose the depth of ulcer by EUS. Forty-eight patients were divided into three treatment groups. Group A (n = 16) was treated with 800 mg cimetidine daily, group B (n = 22) with 20 mg omeprazole daily, and group C (n = 10) with 400 mg cimetidine + 300 mg gefarnate daily. EUS was performed before and after 2, 4, and 8 weeks of treatment. The groups were compared from the viewpoints of endoscopic findings and contraction rate of the length and the cross-sectional area of the ulcer in EUS pictures. The best healing of both the endoscopic and EUS findings was seen in group B. By estimating the changes inside the ulcer, EUS may provide useful information for choice of anti-ulcer agents.

Topics: Anti-Ulcer Agents; Cimetidine; Drug Therapy, Combination; Female; Gastroscopy; Gefarnate; Humans; Male; Methods; Middle Aged; Omeprazole; Stomach; Stomach Ulcer; Ultrasonography

In the healing test of acetic acid ulcers in rats with limited food-intake-time, Z-103 given, p.o., at doses of 3 and 10 mg/kg, twice a day, for 14 consecutive days from the day after acetic acid injection not only reduced the size and depth of the ulcers, but also promoted the regeneration of the defective mucosa. In the hydrocortisone-induced relapse test of acetic acid ulcers in rats with limited food-intake-time, Z-103 given, p.o., twice a day, at doses of 3 and 10 mg/kg for 20 consecutive days from the 40th day after the acid injection strongly prevented the exfoliation of the regenerated mucosa. Cimetidine (100 mg/kg x 2/day, p.o.), like Z-103, showed a marked relapse-preventive action in addition to the healing-promoting action. However, it was more effective on the healing. Gefarnate (300 mg/kg x 2/day, p.o.) markedly reduced the size and depth of the ulcers and strongly prevented the steroid-induced relapse, but showed no apparent effect on the regeneration of the defective mucosa. These results suggest that Z-103 may be a new therapeutic agent sharing both healing-promoting and relapse-preventive actions on gastric ulcers.

Topics: Acetates; Animals; Anti-Ulcer Agents; Carnosine; Chlorides; Cimetidine; Diet; Eating; Gastric Mucosa; Gefarnate; Hydrocortisone; Male; Organometallic Compounds; Rats; Rats, Inbred Strains; Recurrence; Stomach Ulcer; Wound Healing; Zinc; Zinc Compounds

Cost-benefit analysis (CBA) and cost-effectiveness analysis (CEA) are increasingly being used in medical practice and in health policy making. The choice among alternative treatments, the aim of a more efficient use of limited resources and the wider goal of cost containment, are so many reasons for CBA and CEA. This paper addresses the rather unexplored field of long-term cost-benefit analysis. Gastric ulcer, which is a recurrent disease is taken as a case study. Mathematical modelling is used for situation analysis of alternative long-term intervention strategies. The use of recurrence in the model makes the results of earlier CBA's based on the healing of a single episode, open to question. The paper holds important lessons for both the theoretical aspects of CBA and for its utilization in health policy formulation.

Topics: Cimetidine; Cost-Benefit Analysis; Gefarnate; Humans; Japan; Models, Theoretical; Polyenes; Recurrence; Stomach Ulcer

The anti-ulcer effect of sofalcone, an isoprenyl chalcone derivative, on acetic acid-induced gastric ulcers in rats was studied histologically and histochemically. After administrations of sofalcone at 50 and 200 mg/kg twice daily for 10 days, contraction of the ulcer, mucosal regeneration, accelerated development of the collagen fibers in the granulation tissue at the base of the ulcer, and increase of acid mucopolysaccharides, an alcian blue stain-positive substance covering the regenerated mucosa, were noted. The healing effect of sofalcone was balanced in mucosal regeneration and connective tissue proliferation (formation of the collagen fibers). Sofalcone of 50 mg/kg showed a greater healing effect than gefarnate at the same dose and had a similar healing effect as L-glutamine at 200 mg/kg.

Topics: Acetates; Acetic Acid; Animals; Anti-Ulcer Agents; Cell Division; Chalcone; Chalcones; Gastric Mucosa; Gefarnate; Glutamine; Male; Propiophenones; Rats; Rats, Inbred Strains; Staining and Labeling; Stomach Ulcer

Effects of 3,4,5-trimethoxy-N-(3-piperidyl) benzamide (KU-54), an antiulcer drug, on the tissue respiration of the gastric mucosa and the liver were studied in rats. Oral KU-54 at 100 mg/kg twice daily for 5 days (though it was given only once on the 5th day) caused an increase in oxygen consumption of the gastric mucosa in rats, but did not affect that of the liver. Thus the principal active site of KU-54 on tissue respiration was found to be the gastric mucosa. Oral KU-54 at 100 mg/kg once daily for 11 days significantly accelerated the oxygen consumption of marginal gastric mucosa of acetic acid ulcer in rats. The effect of oral gefarnate at 200 mg/kg was about half that of KU-54 at 100 mg/kg, but it was not significant. In addition, oral KU-54 at 100 mg/kg twice daily for 5 days (though it was given only once on the 5th day) significantly inhibited the decrease of oxygen consumption of the gastric mucosa in hemorrhagic shocked rats. The effect of oral gefarnate at 100 mg/kg was not like that at KU-54 at 100 mg/kg in conscious rats. When KU-54 was added in the incubation medium with small gastric mucosal fragments of rats, the increase of oxygen consumption of the gastric mucosa did not occur. Oral KU-54 at 100 mg/kg significantly accelerated a glycogen consumptive stimulation of the gastric mucosa of the corpus in ischemic rats, but the respiration of the antral mucosa was not accelerated under anaerobic incubating conditions. Oral gefarnate at 200 mg/kg accelerated an anaerobic glycolysis of the gastric antral mucosa in rats.

Topics: Animals; Anti-Ulcer Agents; Gastric Mucosa; Gefarnate; Glycolysis; In Vitro Techniques; Liver; Male; Oxygen Consumption; Piperidines; Rats; Rats, Inbred Strains; Stomach Ulcer

Antiulcer effects of geranylgeranylacetone (GGA) on aspirin-induced gastric ulcers in rats were studied, comparing them with those of gefarnate. The oral administration of GGA prevented the development of gastric ulcer induced by a single or repeated oral administration (5 consecutive days) of aspirin. The effects of GGA were more potent and more definite than those of gefarnate. The intraduodenal administration of GGA, but not the intragastric administration, also inhibited the ulceration induced by aspirin in pylorus-ligated rats, while the intraduodenal administration of gefarnate did not. GGA prevented the reduction of the H+ concentration and the increment of Na+ concentration in the gastric juice induced by aspirin. In addition, the decrease of hexosamine content in the gastric mucosa induced by aspirin was restored to a normal level by GGA, but not by gefarnate. From these results, it was concluded that the protective actions of GGA on aspirin-induced gastric ulcers might be due to its protection from the weakening of gastric mucosal resistances.

Topics: Animals; Aspirin; Diterpenes; Gastric Mucosa; Gefarnate; Hexosamines; Male; Rats; Rats, Inbred Strains; Stomach Ulcer

Topics: Drug Therapy; Gefarnate; Stomach Ulcer; Terpenes

Topics: Gefarnate; Pharmacology; Phenylbutazone; Prednisolone; Rats; Research; Stomach Ulcer; Terpenes; Toxicology