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Article: Maintenance therapy for duodenal ulcer: A randomized controlled comparison of seven forms of treatment

TitleMaintenance therapy for duodenal ulcer: A randomized controlled comparison of seven forms of treatment
Authors
Issue Date1992
PublisherExcerpta Medica, Inc. The Journal's web site is located at http://www.elsevier.com/locate/amj
Citation
American Journal Of Medicine, 1992, v. 92 n. 3, p. 265-274 How to Cite?
AbstractPURPOSE: We performed a randomized controlled trial to compare the efficacy of seven forms of maintenance treatment of duodenal ulcer, including a mealtime regimen of antacids. PATIENTS AND METHODS: We randomized 785 patients with healed duodenal ulcer to receive: (1) no treatment; (2) mealtime antacids with an acid-neutralizing capacity of 80 mmol/day; (3) an antidepressant, trimipramine 25 mg; (4) an anticholinergic, pirenzepine 50 mg; (5) cimetidine 200 mg; (6) cimetidine 400 mg; (7) ranitidine 150 mg; or (8) sucralfate 1 g twice a day. Symptomatology and side effects were assessed every 2 months and endoscopy was performed every 4 months up to 1 year. RESULTS: The patients were comparable in the majority of clinical characteristics before entry. The cumulative percentages of patients with relapse of ulcers at 12 months by life-table analysis were 61% with no treatment, 38% with mealtime antacids, 60% with trimipramine, 52% with pirenzepine, 46% with cimetidine 200 mg, 44% with cimetidine 400 mg, 30% with ranitidine 150 mg, and 40% with sucralfate. Cimetidine 400 mg, antacids, ranitidine 150 mg, and sucralfate were significantly better than no treatment and the other forms of treatment. Ranitidine was significantly better than antacids, cimetidine, and sucralfate in preventing endoscopically documented duodenal ulcer relapse by multiple comparison at 12 months, but not by life- table analysis nor when symptomatic relapses were compared. No significant difference was detected among antacids, cimetidine, and sucralfate. No major side effects occurred with the seven forms of treatment, but those receiving antacids had the highest incidence of minor adverse events (26%). CONCLUSION: This study suggests that mealtime antacids are as effective as H 2-receptor antagonists and sucralfate in the maintenance treatment of duodenal ulcer disease, but have to be taken three times a day and had the highest incidence of reported minor adverse events. The relapse rate was lower with ranitidine than with cimetidine, sucralfate, and antacids, but the difference was small and may not be clinically important.
Persistent Identifierhttp://hdl.handle.net/10722/161918
ISSN
2015 Impact Factor: 5.61
2015 SCImago Journal Rankings: 2.023
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorWai Mo Huien_US
dc.contributor.authorShiu Kum Lamen_US
dc.contributor.authorAnna Suk Fong Loken_US
dc.contributor.authorMatthew Ma Tai Ngen_US
dc.contributor.authorChing Lung Laien_US
dc.date.accessioned2012-09-05T05:16:01Z-
dc.date.available2012-09-05T05:16:01Z-
dc.date.issued1992en_US
dc.identifier.citationAmerican Journal Of Medicine, 1992, v. 92 n. 3, p. 265-274en_US
dc.identifier.issn0002-9343en_US
dc.identifier.urihttp://hdl.handle.net/10722/161918-
dc.description.abstractPURPOSE: We performed a randomized controlled trial to compare the efficacy of seven forms of maintenance treatment of duodenal ulcer, including a mealtime regimen of antacids. PATIENTS AND METHODS: We randomized 785 patients with healed duodenal ulcer to receive: (1) no treatment; (2) mealtime antacids with an acid-neutralizing capacity of 80 mmol/day; (3) an antidepressant, trimipramine 25 mg; (4) an anticholinergic, pirenzepine 50 mg; (5) cimetidine 200 mg; (6) cimetidine 400 mg; (7) ranitidine 150 mg; or (8) sucralfate 1 g twice a day. Symptomatology and side effects were assessed every 2 months and endoscopy was performed every 4 months up to 1 year. RESULTS: The patients were comparable in the majority of clinical characteristics before entry. The cumulative percentages of patients with relapse of ulcers at 12 months by life-table analysis were 61% with no treatment, 38% with mealtime antacids, 60% with trimipramine, 52% with pirenzepine, 46% with cimetidine 200 mg, 44% with cimetidine 400 mg, 30% with ranitidine 150 mg, and 40% with sucralfate. Cimetidine 400 mg, antacids, ranitidine 150 mg, and sucralfate were significantly better than no treatment and the other forms of treatment. Ranitidine was significantly better than antacids, cimetidine, and sucralfate in preventing endoscopically documented duodenal ulcer relapse by multiple comparison at 12 months, but not by life- table analysis nor when symptomatic relapses were compared. No significant difference was detected among antacids, cimetidine, and sucralfate. No major side effects occurred with the seven forms of treatment, but those receiving antacids had the highest incidence of minor adverse events (26%). CONCLUSION: This study suggests that mealtime antacids are as effective as H 2-receptor antagonists and sucralfate in the maintenance treatment of duodenal ulcer disease, but have to be taken three times a day and had the highest incidence of reported minor adverse events. The relapse rate was lower with ranitidine than with cimetidine, sucralfate, and antacids, but the difference was small and may not be clinically important.en_US
dc.languageengen_US
dc.publisherExcerpta Medica, Inc. The Journal's web site is located at http://www.elsevier.com/locate/amjen_US
dc.relation.ispartofAmerican Journal of Medicineen_US
dc.subject.meshAdulten_US
dc.subject.meshAntacids - Administration & Dosage - Adverse Effects - Therapeutic Useen_US
dc.subject.meshCimetidine - Administration & Dosage - Adverse Effects - Therapeutic Useen_US
dc.subject.meshDuodenal Ulcer - Drug Therapy - Epidemiology - Pathologyen_US
dc.subject.meshEndoscopy, Gastrointestinalen_US
dc.subject.meshFemaleen_US
dc.subject.meshHong Kong - Epidemiologyen_US
dc.subject.meshHospitals, Universityen_US
dc.subject.meshHumansen_US
dc.subject.meshLife Tablesen_US
dc.subject.meshLogistic Modelsen_US
dc.subject.meshMaleen_US
dc.subject.meshPirenzepine - Administration & Dosage - Adverse Effects - Therapeutic Useen_US
dc.subject.meshRanitidine - Administration & Dosage - Adverse Effects - Therapeutic Useen_US
dc.subject.meshRecurrenceen_US
dc.subject.meshRisk Factorsen_US
dc.subject.meshSucralfate - Administration & Dosage - Adverse Effects - Therapeutic Useen_US
dc.subject.meshTrimipramine - Administration & Dosage - Adverse Effects - Therapeutic Useen_US
dc.titleMaintenance therapy for duodenal ulcer: A randomized controlled comparison of seven forms of treatmenten_US
dc.typeArticleen_US
dc.identifier.emailChing Lung Lai:hrmelcl@hku.hken_US
dc.identifier.authorityChing Lung Lai=rp00314en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1016/0002-9343(92)90076-Nen_US
dc.identifier.pmid1546725-
dc.identifier.scopuseid_2-s2.0-0026504898en_US
dc.identifier.volume92en_US
dc.identifier.issue3en_US
dc.identifier.spage265en_US
dc.identifier.epage274en_US
dc.identifier.isiWOS:A1992HH56600008-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridWai Mo Hui=7409779346en_US
dc.identifier.scopusauthoridShiu Kum Lam=7409550162en_US
dc.identifier.scopusauthoridAnna Suk Fong Lok=35379868500en_US
dc.identifier.scopusauthoridMatthew Ma Tai Ng=16224427600en_US
dc.identifier.scopusauthoridChing Lung Lai=7403086396en_US

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