LOW-DOSE MAINTENANCE TREATMENT WITH CIMETIDINE IN DUODENAL-ULCER - INTERMEDIATE-TERM RESULTS

Ulcer relapse rates during up to 2 years of prophylactic low-dose maintenance therapy (LDMT) with cimetidine 400 mg at bedtime was examined in 261 patients. Endoscopy was repeated every 6 months if asymptomatic, or whenever symptoms recurred. Relapse was defined as the recurrence of an ulcer crater or erosions or both. In patients with non-refractory duodenal ulcer (those healed within 3 months) who comprise the majority, their likelihood of relapse at 6, 12, 18 and 24 months was: symptomatic 8%, 13%, 18%, 20%; silent 14%, 28%, 38%, 43%, respectively. In contrast, in patients with refractory ulcer, their symptomatic relapse rates were 36%, 45%, 46%, 48% and silent 28%, 38%, 46%, 48% respectively. The outcome of a second course of LDMT was simialr to the first. Narrowing the definition of relapse to exclude recurrence of erosions alone but without an ulcer decreased asymptomatic relapse in non refractory ulcer patients by about half. No patient had any major side effects. Thus, LDMT is a safe and effective way of keeping most patiens with duodenal ulcer symptom free over 2 years.