Cimetidine and peptic ulcer.
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Cimetidine↗
Biomedical subjects
D J Hetzel
Publications and source records attributed to D J Hetzel.
Relapse rate of duodenal ulcer after cessation of long-term cimetidine treatment: a double-blind controlled study.
Patients with a healed duodenal ulcer and who were symptom-free following 12 months of maintenance treatment with cimetidine 400 mg twice daily were randomized double-blind to a further 6 months therapy with either cimetidine 400 mg twice daily or placebo 2 tablets twice daily. Twenty-six patients received placebo and 15 patients cimetidine. Relapse was defined as symptoms for 3 out of 7 consecutive days and ulcer recurrence was confirmed by independent endoscopy. One of 15 patients on cimetidine relapsed: 20 of 26 patients on placebo relapsed. This relapse rate (77%) is similar to that found in previous studies after only 6 weeks cimetidine therapy (71%). This study suggests that 12 months cimetidine does not change the tendency of duodenal ulcer to recur and that the relapse rate is no greater than after 6 weeks cimetidine.
Adolescent↗
Prevention of duodenal ulcer relapse by cimetidine: a one-year double-blind trial.
Fifty-one patients with duodenal ulcer which was healed by a six-week course of cimetidine completed a one-year double-blind study to compare the effects of cimetidine and placebo on the prevention of ulcer relapse. Patients were allocated at random to receive either 400 mg of cimetidine twice daily or placebo. Ulcer relapse was assessed by regular clinical follow up and endoscopy. A total of six of the 24 cimetidine-treated patients (25%) suffered a relapse compared to 25 of the 27 of placebo-treated patients (92.6%). Out of this total number of relapses, asymptomatic relapse with ulceration discovered by routine endoscopy at six months or one year, occurred in three patients receiving cimetidine and eight patients receiving placebo. Cimetidine prevents recurrence in patients with duodenal ulcer disease.
Adult↗
Cimetidine treatment of duodenal ulceration: short term clinical trial and maintenance study.
Eighty-five patients with endospcopically confirmed duodenal or pyloric canal ulcers entered a double blind trial with 1200 mg of cimetidine per day or placebo for 6 weeks. Eighty-four per cent of patients treated with cimetidine and 38 percent of those receiving placebo healed their ulcers (P less than 0.001). Measurement of basal acid output and maximal acid output before and after treatment showed no significant change but patients who failed to heal their ulcers had a higher basal acid output and maximal acid output than those who healed. Patients who smoked or drank alcohol had the same healing rate as abstainers. Sity-seven patients with duodenal ulceration healed by a 6-week course of cimetidine were randomly allocated to 400 mg of cimetidine twice daily or placebo in the maintenance trial. Actuarial analysis of the number of relapses in each group demonstrates that cimetidine is highly effective in preventing relapse.
Adult↗
Cimetidine in the treatment of duodenal ulcer.
In a double-blind trial performed in two centres, 67 outpatients with endoscopically confirmed duodenal (55) or pyloric canal (12) ulcers received cimetidine (34 patients) or placebo (33 patients) for six weeks. At 6 weeks complete healing of ulcers was significantly increased in patients receiving cimetidine (82%) compared with those receiving placebo (39%) (chi2=11-27; P less than 0-0008). Patients receiving cimetidine had significantly less daytime pain and required less antacid than those receiving placebo. Gastric acid secretion measured one week after cessation of treatment demonstrated that there was no rebound hypersecretion of acid in patients who had received cimetidine. The pretrial basal acid output of those patients whose ulcers failed to heal during cimetidine therapy was significantly greater than that of those whose ulcers healed during treatment with the drug (P less than 0-001). No side effects were encountered.
Adult↗
Risk factors for ulcerative reflux oesophagitis: a case-control study.
A case-control study was undertaken to investigate the effects of smoking, alcohol consumption, use of non-steroidal anti-inflammatory and other analgesic medications and family and medical history on the risk of ulcerative reflux oesophagitis (URO). We recruited 191 cases with URO diagnosed at endoscopy, 162 hospital controls who had also undergone endoscopy and 140 community controls from the Adelaide metropolitan area. From these three groups of subjects, 134 case-community control pairs, Matched on age, sex and postcode of residence and 142 case-hospital control pairs, matched on age, sex, hospital and endoscopist, were formed. Elevated non-significant risks were found in those smoking at least 20 cigarettes per day relative to those who never smoked (relative risk = 1.9, 95% confidence interval: 0.9-3.9 in case-hospital control pairs; relative risk = 1.9, 95% confidence interval: 0.9-3.7 in case-community control pairs). There was no elevation in risk associated with the use of non-steroidal anti-inflammatory drugs, with alcohol consumption, factors related to medical and reproductive history, nor with family history except for paternal history of heartburn (relative risk = 2.5, 95% confidence interval: 1.2-5.4 in case-hospital control pairs; relative risk = 1.9, 95% confidence interval: 1.0-4.0 in case-community control pairs). With the possible exception of smoking, no other risk factors for ulcerative reflux oesophagitis related to lifestyle are apparent.
Adult↗