RECURRENCE OF ACUTE DUODENAL-ULCER

Nizatidine, 300 mg once nightly, was compared with cimetidine, 800 mg once nightly, for treatment of 212 adult out-patients with acute duode nal ulcers in an eight-week randomized, double-blind, multicentre tria l. Patients were endoscoped at weeks 2, 4 and 8, regardless of ulcer h ealing status. No significant differences in ulcer healing rates betwe en treatment groups were seen at weeks 2 and 4, but at week 8, nizatid ine had a significantly higher ulcer healing rate (P=0.36) than cimeti dine (86% versus 74%, respectively). Patients with healed ulcers at ei ther week 2 or week 4 had a final endoscopy performed at week 8. The r ate of ulcer recurrence was significantly greater (P=0.021) in the cim etidine group at week 8 compared with the nizatidine group: 21% versus 7.3%. respectively. Increasing tolerance to H-2 receptor antagonist t herapy with prolonged use may explain the higher recurrence rate of ci metidine. Both drugs provided equally rapid and effective symptomatic relief from epigastric pain after two weeks of therapy. Both were equa lly safe and free from treatment-related adverse effects.