Effect of repeated oral administration of BY 1023/SK&F 96022--a new substituted benzimidazole derivative--on pentagastrin-stimulated gastric acid secretion and pharmacokinetics in man

Pentagastrin stimulated gastric secretion was measured in 12 healthy male subjects after repeated once daily oral administration of 20 and 40 mg BY 1023/SK&F 96022--a new substituted benzimidazole derivative. Twenty milligrams inhibited acid output compared with placebo by 24% (2.5-3.5 h) and 26% (24.5-25.5 h) after the first oral intake. Inhibition increased to 56% and 50%, respectively, after the seventh oral dose. Forty milligrams inhibited acid output by a mean of 51% (2.5 to 3.5 h) and 52% (24.5-25.5) after the first oral intake. After the seventh dose mean inhibition rose to 85% and 66%, respectively. The drug was well tolerated, no drug-related changes in clinical laboratory, ECG, heart rate and blood pressure were observed. Fasting gastrin serum concentrations tended to increase with both doses, the mean values being within the normal range. AUC, Cmax and t1/2 of the drug after repeated oral intake were not significantly different when compared with a single dose at either 20 mg or 40 mg.

[Gastrointestinal tolerance of 30 mg versus 300 mg acetylsalicylic acid daily. An endoscopically controlled double-blind study of healthy subjects]

Acetylsalicylic acid (ASS) is increasingly used in the prevention of cardiovascular diseases. In recent years daily ASS-doses (100 to 300 mg) have been given for this indication. Studies with still lower ASS-doses (f. i. 30 mg daily) are the focus of ongoing clinical trials. In a randomized double-blind study we have evaluated the gastroduodenal tolerability of 30 mg ASS and 300 mg ASS daily in 20 healthy volunteers using upper GI-endoscopy. Both ASS-dosages have been taken for a period of four weeks. Endoscopic controls were performed at entry and repeated after seven, 14 and 28 days of treatment. 30 mg ASS daily did not induce significant gastroduodenal damages during the whole treatment period in contrast to 300 mg ASS daily (p less than 0.05). The lesions score under 300 mg ASS on day 7 and 28 was almost identical. Our data suggest that extremely low doses of ASS are almost harmless to the human gastroduodenal mucosa. No adaptive phenomena occur during a 28 days treatment with 300 mg ASS daily.

Single intravenous administration of the H+, K(+)-ATPase inhibitor BY 1023/SK&F 96022--inhibition of pentagastrin-stimulated gastric acid secretion and pharmacokinetics in man

The effects of H+, K(+)-ATPase inhibitor BY 1023/SK&F 96022 on pentagastrin-stimulated acid secretion have been studied in healthy male volunteers (n = 12). The gastric acid response to submaximal pentagastrin-stimulation (0.6 micrograms/h/kg b.w.) was dose-dependently inhibited. A single dose of 5 mg decreased acid output by 22% while after 60 mg and 80 mg secretion was almost completely abolished. A good dose linearity was observed for AUC (0, infinity) and Cmax over the dose range from 5 to 80 mg. Elimination half-life, total clearance and volume of distribution of the parent compound were independent of the dose. The drug was well tolerated up to the highest dose of 80 mg. No clinically relevant influence was found on either laboratory screen or cardiovascular parameters.

[Treatment of hyperlipoproteinemia in patients with diabetes mellitus]

In a large percentage of cases, diabetes mellitus leads to hyperlipidemia. In addition to the diabetes-related secondary hyperlipidemias, all types of primary disturbances of lipid metabolism can also be observed in diabetics. Depending upon the degree of severity and type of metabolic disorder presenting, not only suitable dietetic treatment, but also the various lipid-lowering drugs, fibrates, nicotinic acid, probucol, cholestyramine and the HMG-CoA reductase inhibitors should be introduced into therapy. As in all groups with an elevated coronary risk, strict management of the lipid levels is mandatory in diabetics, too.

Epithelial glycoprotein is a member of a family of epithelial cell surface antigens homologous to nidogen, a matrix adhesion protein

The cell surface antigen, epithelial glycoprotein, defined by the monoclonal antibody HEA 125, is expressed on virtually all epithelial cell membranes but not on mesodermal or neural cell membranes. The cDNA encoding epithelial glycoprotein was isolated by HEA 125 antibody enrichment of colon tumor cDNA expressed transiently in COS cells. The sequence of the epithelial glycoprotein antigen is identical to the cell membrane protein recognized by the monoclonal antibody KS 1/4 and is homologous to the tumor-associated antigen GA733. These proteins share sequence homology to nidogen, an extracellular matrix component that appears to participate in cell-matrix adhesion. These proteins also share a homologous domain found in the B1 chain of laminin, a matrix adhesion protein, and placental protein 12, an insulin-like growth factor I binding protein secreted during pregnancy that has been implicated in regulation of fetal growth. This common domain is also repeated multiple times within the thyroglobulin precursor. These findings suggest epithelial glycoprotein is a cell surface molecule involved in cell-cell or cell-matrix interaction.

[Endoscopic studies on the gastric tolerance of paracetamol and acetylsalicylic acid. A placebo-controlled, double-blind study in healthy volunteers]

Endoscopic Studies on the Gastric Tolerance Following 6 Days Treatment of Paracetamol and Acetylsalicylic Acid/A placebo-controlled double-blind-study in healthy volunteers. In placebo-controlled randomized double-blind cross-over-fashion the gastric and duodenal tolerance of a 6 day treatment with 3000 mg acetylsalicylic acid (ASA; as a commercially available preparation) and 3000 mg paracetamol (Tylenol) were directly compared in 12 healthy volunteers. An endoscopic evaluation of the gastric and duodenal mucosa was performed. 3000 mg ASA daily evoked significant more gastro-duodenal lesions than 3000 mg paracetamol daily and placebo. Difference between Paracetamol and placebo did not reach statistical significance. Based on the comparable analgetic potency of both compounds and the apparently better gastro-duodenal tolerability paracetamol is the drug of choice when a non-inflammatory problem requires an analgesic.

[Stomach tolerance of buffered and unbuffered low-dose acetylsalicylic acid: an endoscopy controlled double-blind study in volunteers]

In this randomised double-blind cross-over study the gastroduodenal tolerability of buffered acetylsalicylic acid (ASS) (Aspalox = 325 mg ASS plus 300 mg magnesium aluminium hydroxide) daily has been compared with unbuffered ASS (325 mg) daily in 12 healthy volunteers using upper Gl-endoscopy. The treatment period lasted 14 days: endoscopic controls were performed at entry and repeated at day 14. At day 0 the mean endoscopic score averaged 0.8 +/- 0.1 in both groups (MW +/- SEM). One tablet Aspalox daily induced marked gastroduodenal damage at day 14 (6.5 +/- 1.5). The median lesion score rose from 1.0 (day 0) to 7.0 at day 14. Unbuffered ASS evoked almost identical gastroduodenal injuries at day 14 (7.5 +/- 1.8). The corresponding median values were 1.0 (day 0) and 7.0 at day 14. Our data suggest, that the amount of buffering in the Aspalox preparation is not sufficient enough to protect human gastroduodenal mucosa against low dose acetylsalicylic acid.

[Effective prevention of piroxicam-induced lesions of the gastric mucosa with nizatidine]

12 healthy volunteers participated in this single-blind, randomized, cross-over study. All subjects were given Piroxicam 20 mg mane on three different 14 days treatment periods in the presense of Nizatidine 150 or 300 mg bid and placebo respectively. Only subjects without endoscopically revealed gastroduodenal lesions were enrolled into the study. Endoscopy was repeated at day 14 of therapy. Between treatment periods a 2 weeks wash out phase was interposed. The gastroduodenal lesion score was the following: score 0 = no injury, score 1 = erythema, score 2 = less than or equal to 9 lesions, score 3 = greater than or equal to 10 lesions (petechiae/erosions), score 4 = ulcer. The mean lesion score with Piroxicam averaged 1.5 +/- 0.35 (+/- SEM) when placebo was coadministered. The mucosal lesion scores were reduced to 0.17 +/- 0.08 and 0.42 +/- 0.19 (+/- SEM) when Nizatidine 150 or 300 mg bid was given concurrently. This protection afforded by Nizatidine was significant when compared with placebo (p less than 0.01). The difference between the two Nizatidine doses, however, did not reach statistical significance. Our data suggest that Nizatidine markedly improves the gastroduodenal tolerability of Piroxicam.

[3 mg telenzepine nocte in the treatment of benign stomach ulcer disease: a double-blind comparative study with 300 mg ranitidine nocte]

163 patients with endoscopically proven benign gastric ulcers were randomly allocated to treatment with either telenzepine 3 mg nocte or ranitidine 300 mg nocte for up to 8 weeks in a prospective double-blind study. The two groups were similar with regard to age, sex, number of patients with ulcer recurrence, smoking habits etc. After 4 weeks treatment 51/80 patients (64%) healed on telenzepine 3 mg nocte and 49/83 patients (59%) on ranitidine 300 mg nocte. The corresponding healing rates after 8 weeks were 85% (68/80) on telenzepine and 89% (74/83) on ranitidine. At each time there was no statistical difference between the two groups. After 8 weeks of treatment 58 patients (73%) on telenzepine and 72 patients (87%) on ranitidine were totally free from stomach pain (n.s.). Other ulcer related symptoms such as fullness etc. were more rapidly relieved with ranitidine. Anticholinergic side effects occurred significantly more frequent in patients on telenzepine than in patients on ranitidine. Dry mouth was the most frequent side effect in the telenzepine group. Telenzepine 3 mg at night appears to be as good as ranitidine 300 mg at night in the healing of benign gastric ulcer disease.

[Ranitidine protects the human stomach and duodenal mucosa against low-dose acetylsalicylic acid]

In a randomized double-blind study the gastroduodenal tolerability of 300 mg ASS daily has been evaluated in the presence of 150 mg ranitidine bid or placebo in 20 healthy volunteers using upper GI-endoscopy. The treatment period lasted 14 days. Endoscopic controls were performed at entry, and repeated at day 7 and day 14. At entry, the mean endoscopic score averaged 0.8 +/- 0.1 in the ASS/placebo-group and 1.0 +/- 0.0 in the ASS/ranitidine group. 300 mg ASS daily induced in the placebo experiments marked gastroduodenal alterations both at day 7 and day 14 (4.7 +/- 1.2 and 6.5 +/- 2.1, respectively). Concomitant administration of 150 mg ranitidine bid afforded almost full protection against 300 mg ASS daily both on day 7 and day 14 (1.9 +/- 0.6 and 2.1 +/- 0.8, respectively) (p less than 0.05). Our data suggest that coadministration of ranitidine 150 mg bid reduces almost completely gastroduodenal lesions evoked by acetylsalicylic acid 300 mg daily.

[Lowering of the plasma lipid concentration with lovastatin. A clinical study in patients with primary hypercholesterolemia]

A study of 27 patients (18 males and 9 females; median age 57 [35-70] years) with hypercholesterolaemia examined the lipid-reducing effect, clinical reliability and tolerance of lovastatin, an HMG-CoA-reductase inhibitor, given in a single evening dose. After a four-week period on placebo and a lipid-reducing diet the patients received 20 mg lovastatin for four weeks. If, at the end of this period, total cholesterol levels were still above 200 mg/dl, the dose was increased to 40 mg, after a further four weeks to 80 mg. After a three-month treatment period total cholesterol concentration in lovastatin-treated patients was 28% lower than in the placebo group (289.4 +/- 42.2 vs 208.0 +/- 39.9 mg/dl; P less than 0.0001). LDL-cholesterol concentration had fallen by 40% (215.1 +/- 44.4 vs 130.1 +/- 24.7 mg/dl; P less than 0.0001), while plasma triglyceride concentrations had fallen by 15% (166.3 +/- 71.8 vs 141.8 +/- 69.8 mg/dl; P less than 0.01). At the same time, HDL-cholesterol levels had risen by 12% (42.9 +/- 12.4 vs 47.9 +/- 18.2 mg/dl; P less than 0.01). These results confirm the marked lipid-reducing effect of lovastatin.

[Treatment of non-steroidal anti-inflammatory drug-induced damage to gastric mucosa using ranitidine. Comparison of the effectiveness of 2 dosages]

339 patients with rheumatic diseases suffering from dyspepsia and endoscopically proven gastroduodenal lesion entered an open multicenter study with ranitidine 150 mg bid or ranitidine 300 mg administered at night in a single dose over 4 weeks. For entry the patients had to have been treated for at least 3 months with the non-steroidal anti-inflammatory drugs diclofenac, indomethacin and piroxicam. During the trial all patients were continued on NSAID. The data of 248 patients were evaluable. At entry, patients in both treatment groups had a total gastric damage score of 2.0. The duodenal lesion score was on average 1.43 in the ranitidine 150 mg bid group, and 1.8 in the 300 mg single dose ranitidine at night group. After 4 weeks of treatment the mean lesion score was significantly reduced in the stomach as well as in the duodenum with both ranitidine regimens, no differences being seen between the groups. In addition, rapid symptomatic relief was observed in both groups. After 4 weeks of treatment more than 80% of the patients were symptom-free or markedly improved.

Effects of long-term exposure to hydrostatic pressure per se (101 ATA) on eel metabolism

Oxygen consumption, MO2, has been measured in yellow freshwater eels (Anguilla anguilla L.) exposed in normoxic conditions for 31 days at a hydrostatic pressure of 101 ATA (atmosphere absolute; 1 ATA = 0.1 MPa) using a high pressure water circulation system. The results (series I) show that from a maximal value observed at the end of compression, MO2 decreases exponentially with time (tau congruent to 1.4 days) then reaches a steady state (MO2 = 0.67 +/- 0.05 mmol.h-1.kg-1) at a lower level than observed at 1 ATA before compression (MO2 = 1.04 +/- 0.03 mmol.h-1.kg-1). These observations are in agreement with the hypothesis that shallow water fish are able to adapt to pressure; the possible mechanisms of this adaptation are discussed. Results from a second experimental series show that fish previously submitted to pressure for 1 month (then decompressed to 1 ATA) adjust faster to a new pressure exposure (4 days later) than fish that have never experienced pressure exposure. This observation suggests that the mechanisms triggered by long-term pressure exposure could persist, at least in part, for several days after decompression to atmospheric pressure.

[Gastroduodenal tolerance of tenoxicam versus diclofenac-Na: an endoscopy double-blind controlled study in healthy probands]

The gastroduodenal tolerability of tenoxicam vs diclofenac-Na was evaluated in a double-blind, parallel group study in 36 healthy male volunteers. The doses used were 20 mg tenoxicam vs 100 mg diclofenac-Na in a retard formulation daily over a period of 14 days. Gastric tolerability was assessed by using upper endoscopy. Gastroscopy was performed at base-line after the dosing period of 14 days and again after a follow-up period of 14 days without any treatment. The mucosal lesions were scored using modified Lanza criteria. In comparison to diclofenac-Na, tenoxicam was significantly better tolerated after a 14-day dosing period (mean gastric score: tenoxicam: 1.3 +/- 0.7; diclofenac-Na: 2.2 +/- 1.1 p = 0.0143). Both treatment groups had comparable scores at base-line and post-study assessments. Tenoxicam and diclofenac-Na were generally well tolerated. Only two volunteers reported intermittent lack of appetite, heartburn, and a feeling of pressure in the stomach. In summary, tenoxicam given as a 20 mg single oral morning dose over a 14-day period was significantly better tolerated than diclofenac 100 mg with regard to gastroduodenal mucosal damage.

Limiting dilution analysis of the T cell response to Plasmodium chabaudi chabaudi in mice

A limiting dilution assay system was developed in order to measure the in-vitro T cell response to antigens of the erythrocytic stages of Plasmodium chabaudi. The conditions of the assay are such that only CD4+ T cells are able to respond. The assay allows the determination of the frequencies of T cells which proliferate and/or which develop into helper cells for antibody production during a primary infection. A specific response from splenic T cells can be measured as early as 7 days after infection, and is still significant 3 months after injection of P. chabaudi. At all times the frequency of proliferating cells was greater than the precursor frequency of T helper cells. This suggests that a proportion of CD4+ T cells in this assay, although they respond to malarial antigen, do not develop into helper cells for antibody production. This limiting dilution assay will be a useful method by which to evaluate the functional heterogeneity of the CD4+ T cell response to malaria antigens.

[Endoscopic studies of gastroduodenal tolerance of 100 mg versus 500 mg acetylsalicylic acid daily: a randomized double-blind study with healthy probands]

Acetylsalicylic acid (ASS) is increasingly used in the prevention of cardiovascular diseases. In recent years lower daily ASS-doses (100-300 mg) have been given for this indication. However, only marginal knowledge is available about the upper GI-tolerability of ASS in this dosage regiment. In a randomized double-blind study we have evaluated the gastroduodenal tolerability of 100 mg ASS and 500 mg ASS daily in 20 healthy volunteers using upper GI-endoscopy. Both ASS-dosages have been taken over a period of 4 weeks. Endoscopic controls were performed at entry and repeated after 7, 14 and 28 days of treatment. 100 mg ASS daily induced during the whole period significant less gastroduodenal damages than 500 mg ASS daily (p less than 0.05). The lesion score of both groups on day 7 and day 28 were almost identical. Our data suggest that even low doses of ASS (100 mg daily) produced gastroduodenal injuries and that no adaptative phenomena did occur during the treatment period.

An alprostadil analogue and human gastric secretion. A double-blind placebo-controlled study of the effects of a capsule and tablet formulation

The effects of single oral doses of 800 and 1200 micrograms of the new alprostadil analogue mexiprostil (prostaglandin E1 16-methyl-16-methoxy derivative, MDL 646), presented as tablet and capsule formulation, on basal and pentagastrin-stimulated acid secretion, were studied in 10 healthy volunteers, using a randomized, double-blind, placebo-controlled, 5-way crossover design. Compared to placebo, administration of mexiprostil resulted in a significant inhibition of basal gastric acid secretion, at both doses and formulations. Pentagastrin-stimulated gastric secretion was reduced to a lesser degree and the differences compared to placebo did not achieve statistical significance when adjustments were made for basal effects present before starting stimulation. Total volume of gastric secretion, under basal conditions, was decreased by both doses and formulations, though the changes were significant only at 1200 micrograms for both formulation. The decrease in volume of gastric secretion during pentagastrin infusion did not reach statistical significance. Basal intragastric pH was increased by both doses and formulation, but the changes were significant only for the capsule formulation, at either dose. Neither dose of mexiprostil prevented the decrease in intragastric pH produced by pentagastrin infusion. Tolerability of mexiprostil was excellent with no unwanted effects reported either during or after the study. No changes in heart rate and systemic blood pressure were observed. Laboratory safety parameters were not altered by mexiprostil. There was no significant difference between the effects of both formulations of mexiprostil on any pharmacodynamic parameter.

Comparison of the gastroduodenal tolerance of tenoxicam and diclofenac Na. A double-blind, endoscopically controlled study in healthy volunteers

The gastroduodenal tolerance of Tenoxicam and Diclofenac Na has been evaluated in a double-blind, parallel group study in 36 healthy male volunteers. The doses used were 20 mg Tenoxicam and 100 mg Diclofenac Na daily in a retard formulation for 14 days. Gastric tolerance was assessed by endoscopy, which was performed at base-line, after the 14 day dosing period and after a 14 day follow-up period without treatment. The mucosal lesions were scored using modified Lanza criteria. Tenoxicam was significantly better tolerated at the end of the 14 day dosing period (mean gastric score: Tenoxicam 1.3; Diclofenac Na 2.2). The two treatment groups had comparable scores at the base-line and post study assessments. Tenoxicam and Diclofenac Na were generally well tolerated. Only two volunteers reported intermittant lack of appetite, heartburn and a feeling of pressure in the stomach.

[Inhibition of 24-hour acidity by nizatidine]

In a randomized, double-blind, placebo-controlled, comparative cross-over study, we studied the effect of four H2-receptor antagonists on intragastric 24-hour acidity, nocturnal volume and acid output. Ten healthy male volunteers were administered 300 mg or 150 mg nizatidine, 800 mg cimetidine, 300 mg ranitidine, 40 mg famotidine, or placebo on several days, in each case at 9:000 PM. Nocturnal intragastric H+ concentration (mmol/l) (11:00 PM to 7:00 AM) was significantly reduced by all H2 blockers compared with placebo. We obtained the following inhibition rates: Cimetidine 67%; ranitidine 95%; famotidine 89%; nizatidine 80% (300 mg) and 69% (150 mg). Nocturnal acid (mmol/l) and volume output (ml/h) were also significantly (compared with placebo) inhibited by all four H2-receptor antagonists. Inhibition of nocturnal acid secretion was almost identical on nizatidine 300 mg nocte, ranitidine 300 mg nocte, famotidine 40 mg nocte, and cimetidine 800 mg nocte. Nizatidine 300 mg nocte and 150 mg nocte exclusively reduced acid secretion at night, without an aftereffect into the following day (8:00 AM to 6:00 PM). These results suggest that the clinical efficacy of these H2-receptor antagonists is identical with respect to healing peptic ulcer disease and providing freedom from pain. It is generally accepted today that gastric acid inhibitors used in the treatment of peptic ulcer disease should interfere with daytime gastric acid secretion as little as possible, particularly since the acid protects the stomach from bacteria ingested with the food during the day.

[Recall rate criteria in a periodontal office]

It was the objective of this study to identify parameters which influence the rate of recall. In 1987 a total of 845 recall treatments were given to 372 patients. Recorded variables were quality of oral hygiene, papilla bleeding index, and number of teeth with pockets greater than 3 mm. These results plus the number of capped teeth were related to the recall rate. Bad oral hygiene and a correspondingly higher papilla bleeding index require a more frequent recall. However, these variables show little influence on the number of teeth with deep pockets. A higher recall rate in patients with bad oral hygiene cannot always prevent gingivitis, but progression of the disease into periodontitis and loss of attachment.

Human gastric acid secretion following repeated doses of AG-1749

The effect of increasing doses (15 mg, 30 mg and 60 mg) of the substituted benzimidazole, AG-1749, on gastric acid secretion and fasting serum gastrin concentration has been studied after repeated administration to healthy volunteers. AG-1749 produced a dose-dependent and profound decrease in basal and stimulated gastric acid secretion in all volunteers, with almost total suppression at the highest dose. The extent of inhibition increased between Day 2 and Day 8 with the 15 and 30 mg doses of AG-1749. The inhibitory effect of AG-1749 appears to be fully reversible as control levels of acid output were reached 7 days after drug withdrawal. Seven days' dosing with 60 mg AG-1749 induced a more than threefold increment of fasting serum gastrin concentration, but this increase was still within the normal range. Seven days after cessation of dosing, fasting serum gastrin concentration returned to a pre-dose level.

[Single evening administration of a new antimuscarinic agent telenzepine in therapy of acute duodenal ulcer. Results of a randomized double-blind comparative study versus pirenzepine]

A multicenter, double-blind, randomized controlled study was conducted in 314 duodenal ulcer patients to compare the efficacy and safety of the antimuscarinics telenzepine and pirenzepine in the treatment of duodenal ulcer. Patients received telenzepine 3 mg (156) once-daily at bedtime or 50 mg pirenzepine (158) two times daily for 2 weeks. If ulcerous lesions persisted treatment was extended to 4 weeks. Efficacy was assessed by relief of ulcer pain and endoscopic findings of ulcer healing. Safety was determined on the basis of side effects and results of laboratory tests. The 2- and 4-week healing rates achieved with telenzepine were 21.1 and 67.3%, respectively, and with pirenzepine they were 20.0 an 69.0%, respectively; the differences in healing rates for the two drugs were not statistically significant. Similarly both drugs provided satisfactory relief of pain. The incidence of untoward effects was 24.5% with telenzepine and 29.7% with pirenzepine, dryness of mouth being most prominent (20.4 vs. 19.3%). With telenzepine blurred vision was reported in a significantly lower rate compared to pirenzepine (0.7 vs. 4.2%, p less than 0.05). Clinically relevant abnormal laboratory tests were not observed. The present study shows for the first time that the newly developed antimuscarinic drug telenzepine is in a single nocturnal dosage regimen (3 mg nocte) as effective as pirenzepine (50 mg bid) in the treatment of duodenal ulcer.

[Ranitidine ameliorates acemetacin and indomethacin-induced changes of the gastroduodenal mucosa, without modifying the pharmacokinetic behavior of both antirheumatic drugs]

12 healthy volunteers participated in this double-blind, randomized, cross-over study. All subjects were given indomethacin (50 mg tid) or acemetacin (60 mg tid) for 6 days in the presence and absence of ranitidine 300 mg at night. At day 6 120 minutes after the last morning dose an endoscopy was performed and the appearance of the gastric and duodenal mucosa was noted. In the indomethacin experiments mean lesion score averaged 2.2 +/- 0.2 (+/- SEM) when placebo was coadministered. In the corresponding acemetacin-series the lesions score was 1.6 +/- 0.1 (+/- SEM). A reduction in mucosal damage occurred in both NSAID-groups when ranitidine 300 mg at night was given concurrently: The mucosal lesions score was reduced to 1.7 +/- 0.2 and to 1.0 +/- 0.1 (+/- SEM), respectively. This protection afforded by ranitidine was significant when compared with placebo (p less than 0.05). In 8 subjects plasma concentrations of acemetacin and indomethacin were determined on day 1 and day 5. The AUC-values of indomethacin and acemetacin in the presence and absence of ranitidine were almost identical when analysed by the paired T-test. The mean plasma concentrations of both antirheumatic agents did not show any difference when coadministered with placebo or ranitidine. Our data suggest that 300 mg ranitidine at night improves the gastroduodenal tolerability of both indomethacin and acemetacin without affecting main pharmacokinetic parameters of both antirheumatics.