PLASMA GASTRIN (BASAL AND POSTPRANDIAL) VARIATIONS IN DUODENAL-ULCER TREATMENT BY EITHER ENPROSTIL OR RANITIDINE - CORRELATIONS WITH RELAPSE RATES

Enprostil, a synthetic E2-prostaglandin efficacious for duodenal ulcer healing, presents both antisecretory and anti-gastrinic effects. This is at variance with the elevation of plasma gastrin observed with ranitidine. Objective. - This leads us to compare enprostil and ranitidine on the following points: a) variations of plasma gastrin (basal and postprandial) parameters over a 6-week conventional treatment; b) correlation studies between ulcer relapses (frequency and temporal evolution) after treatment discontinuation and various gastrinic criteria. Methods. - Among a group of 642 patients followed for ulcer relapse, 165 were considered for gastrin (78 of the << Enprostil >> group and 87 of the << Ranitidine >> group). Results. - Initially, both populations were comparable for clinical and plasma gastrin parameters. After 6 weeks of treatment, the increases in the various gastrin parameters (basal, postprandial peak, integraded) were significantly greater and the absolute values higher (Wilcoxon, P < 0.001) with ranitidine than with enprostil. No correlation was found between relapse occurence after drug discontinuation and these gastrin parameters. Conclusions. - Ranitidine hypergastrinemia seems directly related to gastric hyposecretion whereas its absence with enprostil is likely more dependent upon a specific anti-gastrinic activity than on a reduced antisicretory activity. Those differences in mechanism of action have no consequence on the stability of ulcer obtained by either drug.