FAMOTIDINE FOR HEALING AND MAINTENANCE IN NONSTEROIDAL ANTIINFLAMMATORY DRUG-ASSOCIATED GASTRODUODENAL ULCERATION

Background & Aims: Nonsteroidal anti-inflammatory drugs (NSAIDs) are s trongly associated with gastroduodenal ulceration. How to manage patie nts with NSAID-associated ulcers is a common clinical dilemma. High-do se famotidine in the healing and maintenance of NSAID-associated gastr oduodenal ulceration was therefore evaluated. Methods: One hundred fou r patients with rheumatoid or osteoarthritis who had gastroduodenal ul ceration received famotidine, 40 mg twice daily. Sixteen patients stop ped and 88 continued their NSAID treatment. Ulcer healing was assessed endoscopically at 4 and 12 weeks. Seventy-eight NSAID users with heal ed ulcers were then randomized to receive 40 mg twice daily famotidine or placebo anal underwent endoscopy at 4, 12, and 24 weeks. Results: Cumulative ulcer healing rates at 12 weeks were 89.0% (95% confidence interval [CI], 82.3%-95.7%) for patients who continued NSAID treatment and 100% (95% CI, 82.9%-100.0%) for those who stopped. The subsequent estimated cumulative gastroduodenal ulcer relapse over 6 months for N SAID users who took placebo was 53.5% (95% CI, 36.6%-70.3%). This was reduced to 26.0% (12.1%-39.9%) in patients taking famotidine (P = 0.01 1). Conclusions: High-dose famotidine is effective ulcer healing thera py in patients who stop or continue NSAID treatment and significantly reduced the cumulative incidence of gastroduodenal ulcer recurrence co mpared with placebo when given as maintenance therapy.