In a randomly allocated, double-blind, endoscopically controlled study, 98 patients with
gastric ulcers were treated with either (a
synthetic prostaglandin of E2-like structure)
enprostil 70 micrograms b.d. or 150 mg
ranitidine b.d. The healing rates at 4, 8 and 12 weeks were
enprostil 57, 91 and 94% and for
ranitidine 55, 88 and 98%, respectively. Following
ulcer healing, half the patients were followed for 1 year without treatment and the others were given 70 micrograms
enprostil nocte. Endoscopy was repeated in both groups after 6 and 12 months or if dyspeptic symptoms returned. The recurrence rate without maintenance at 6 and 12 months, following
ranitidine therapy, was 67 and 75%, and after
enprostil therapy 50 and 61%, respectively. On maintenance
enprostil, the recurrence rates were 28 and 40%. Forty-seven per cent of patients who completed maintenance treatment had a proven
ulcer recurrence within 6 months of stopping
therapy. Diarrhoea was a common side-effect of
enprostil therapy. Seven patients were withdrawn because of diarrhoea or
abdominal pain.