Cimetidine treatment for the prevention of recurrence of duodenal ulcer: an international collaborative study

Burland, W. L.; Hawkins, B; Beresford, J.

doi:10.1136/pgmj.56.653.173

Cited by 92 publications

(15 citation statements)

References 9 publications

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“…A dose increase to 450 or 600 mg ranitidine daily will in the majority of cases result in the healing of such 'resistant' peptic ulcer ations after a further 8 weeks of treatment [26,27,39], Since the new H '-K +-ATPase inhibitor omeprazole is significantly more potent and longer acting than ranitidine [18,37,38], the obvious thing to do was to try this new drug in patients resistant to ranitidine treat ment before transferring them to surgical therapy. In view of the high ulcer relapse rate after stopping treatment in chronic pep tic disease, maintenance therapy is the only alternative therapy to surgical intervention [7,19,30], However, surgical methods are disappointing in those patients who do not respond to medical therapy with H?-receptor antagonists [5,15]. Therefore it was of special interest to investigate how patients with ranitidine-resistant ulcers would do on omeprazole maintenance therapy.…”

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confidence: 99%

Therapy with Omeprazole in Patients With Peptic Ulcerations Resistant to Extended High-Dose Ranitidine Treatment

et al. 1988

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94 patients with peptic ulcerations of duodenum, stomach, and esophagus, who did not respond to 3 or more months high-dose (450 or 600 mg) treatment with ranitidine, were treated orally with 40 mg omeprazole daily. After healing all patients were offered long-term maintenance therapy with the same dose for 5 years. In 75 patients the peptic ulcerations healed within 4 weeks, in 13 patients within 8 weeks, and in 3 patients only after an increase to 60 mg omeprazole daily. In 3 patients the ulcers did not heal. So far 83 patients have entered long-term maintenance therapy. 59 of these patients are on the drug between 1 and 4 years. During maintenance therapy with 40 mg omeprazole no relapses have occurred up to now as demonstrated by endoscopy and no drug-related adverse effects were observed. Routine laboratory tests remained without significant changes in all patients including 18 patients with concomitant liver cirrhosis. Serum gastrin levels were already elevated during the initial high-dose ranitidine treatment (106 ± 15.4 pg/ml). 4 weeks after the start of omeprazole treatment serum gastrin levels rose to 4 times normal levels (195 ± 28 pg/ml). Thereafter, no further increase in serum gastrin was observed even up to 4 years of continuous observation. It is therefore concluded that omeprazole is highly effective in healing ranitidine-resistant peptic ulcerations and that omeprazole maintenance therapy with 40 mg omeprazole is safe during the time observed and highly effective in the prevention of ulcer recurrence.

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confidence: 99%

Therapy with Omeprazole in Patients With Peptic Ulcerations Resistant to Extended High-Dose Ranitidine Treatment

et al. 1988

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“…As opposed to long-term Cimetidine regimes [12,13], all the relapses in our Rani tidine-treated patients were symptomatic, al though we cannot rule out asymptomatic relapases in the intervening periods between one endoscopy and another.…”

Section: Discussionmentioning

confidence: 66%

Ranitidine in Long-Term Duodenal Ulcer Treatment: A Multicentre Trial

et al. 1982

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An endoscopically controlled clinical trial on maintenance Ranitidine treatment of scarred duodenal ulcer was carried out in 78 patients, randomly allocated to either 150 mg Ranitidine at night or low-dose antacid when necessary in a 1 -year follow-up study. The maintenance Ranitidine regime prevented ulcer relapse in 23 of 31 cases (74.2%), without any significant adverse reaction. In the control group, the relapse was prevented in 12 of 30 cases (40%); the difference was found to be statistically significant.

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“…Ulcer symptoms and spontaneously reported adverse events were assessed by a physician in each centre before treatment and on days 8,15, and 29 of the study. Patients were also asked to record the BRITISH MEDICAL JOURNAL VOLUME 289 1 SEPTEMBER 1984 whose ulcers healed was similar between the groups, being 9/10, 12/12, 9/10, and 11/11 patients taking omeprazole 20 mg, 30 mg, 40 mg, and 60 mg respectively.…”

Section: Methodsmentioning

confidence: 99%

Omeprazole in duodenal ulceration: acid inhibition, symptom relief, endoscopic healing, and recurrence. Cooperative study.

1984

BMJ

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SEPTEMBER 1984 525Thomas DC. General relative-risk models for survival time and matched casecontrol analysis. Biomzetrics 1981 ;37 :673-86.22Kolterman OG, Gray RS, Griffin J, et al. Receptor and post-receptor defects contribute to the insulin resistance in noninsulin-dependent diabetes mellitus. J withdrawn from the study, all the adverse events resolved spontaneously during continued treatment with the same dose of omeprazole. Pentagastrin tests were performed before the study and after four weeks' treatment. The mean inhibition of peak acid output measured 24 hours after the last dose was 61%, 94%, 91%, and 81% with omeprazole 20 mg, 30 mg, 40 mg, and 60 mg respectively. During the first six months after the end of treatment 11 out of 36 patients had a symptomatic, endoscopically diagnosed recurrence of ulceration; the median time to relapse was 10 (range 6-23) weeks.

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Cimetidine treatment for the prevention of recurrence of duodenal ulcer: an international collaborative study

Cited by 92 publications

References 9 publications

Therapy with Omeprazole in Patients With Peptic Ulcerations Resistant to Extended High-Dose Ranitidine Treatment

Therapy with Omeprazole in Patients With Peptic Ulcerations Resistant to Extended High-Dose Ranitidine Treatment

Ranitidine in Long-Term Duodenal Ulcer Treatment: A Multicentre Trial

Omeprazole in duodenal ulceration: acid inhibition, symptom relief, endoscopic healing, and recurrence. Cooperative study.

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