Double-blind comparison of cimetidine and placebo in the maintenance of healing of chronic duodenal ulceration

Abstract

Patients suffering from chronic duodenal ulceration were allocated at random to treatment with either cimetidine (400 mg twice daily) or matching placebo for 6 mth. Before entry to the trial, all patients were shown to have healed ulcers on endoscopy. Most of the patients had participated in a 1-mth trial of cimetidine during which their ulcers healed. The trial showed that 4 of 29 patients relapsed on maintenance treatment with cimetidine, which therefore did not confer complete immunity from relapse. However, cimetidine treatment was very much better than placebo treatment, on which 18 of 31 patients relapsed. Of the 22 patients who relapsed clinically, 20 were submitted to endoscopy and 19 of these were shown to have ulcerated again. Endoscopy at the end of the trial showed that ulcers had also redeveloped in 5 of 28 asymptomatic patients. Length of previous dyspeptic history had no bearing on the results of the trial, but there was evidence that relapse on placebo was less likely if the ulcer had originally healed on a high dose of cimetidine. Clinical relapse was associated with worsening duodenitis. Symptoms, clinical observation, and laboratory tests showed no important abnormalities in the patients.