Five-year cimetidine maintenance trial for peptic ulcer disease. A clinical and endocrinologic approach.
A multicentre maintenance trial was conducted in 63 peptic ulcer patients to investigate the efficacy and safety of continuous cimetidine maintenance therapy for up to 5 years. In Amsterdam the male patients were investigated yearly for possible endocrinologic changes and to monitor gastric acid secretory capacity. Patients with healed ulcers entered maintenance treatment with a 400-mg bedtime dose of cimetidine. The yearly relapse rates decreased from 20% to 6% from year 1 to year 4. Adverse reactions observed in this study were not different from those previously reported with cimetidine. Endocrinologic studies in 10 male patients showed a small but consistent increase in basal gastrin in the 3rd and 4th year, stabilizing in the 5th year. Prolactin levels showed a gradual increase during the first 3 years but remained well within the normal range. In the 4th and 5th year they decreased again; however, the changes noted were rather modest. It is concluded from this study that weak nocturnal acid inhibition with cimetidine maintenance treatment not only continues to be effective and safe beyond 1 year but also reduces the risk of relapse over time. No relevant endocrinologic abnormalities are to be expected with this regimen of modest nocturnal acid suppression.
Tytgat
G N
GN
Dept. Gastroenterology/Endocrinology, AMC, Free University, Amsterdam, The Netherlands.
Hameeteman
W
W
Mulder
C J
CJ
Wiersinga
W
W
van de Boomgaard
D M
DM
Dees
J
J
D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D002927:Cimetidine / Q000627:therapeutic use*; D016099:Endoscopy, Gastrointestinal; D006728:Hormones / Q000097:blood; D006801:Humans; D008875:Middle Aged; D010437:Peptic Ulcer / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D012008:Recurrence; D012307:Risk Factors; D013997:Time Factors
D006728:Hormones; D002927:Cimetidine