Pantoprazole vs. Ranitidine for Prevention of Peptic Ulcer Rebleeding

Multiple studies and meta-analyses have shown that high-dose proton-pump inhibitor (PPI) therapy reduces rebleeding in patients with peptic ulcers and high-risk endoscopic stigmata. Investigators have evaluated either intravenous or oral omeprazole but have used pantoprazole when IV omeprazole was unavailable. Although it seems logical that pantoprazole would have a similar effect, confirming data are lacking.

Now, investigators have performed a multicenter, international study randomizing 1256 patients with bleeding peptic ulcers and high-risk endoscopic stigmata to pantoprazole (80-mg bolus and 8 mg per hour) or ranitidine (50-mg bolus and 13 mg per hour) after endoscopic therapy. A second-look endoscopy was performed on day 3, or earlier …