Omeprazole or cimetidine once daily for the treatment of duodenal ulcers?

Thai patients (n = 257) entered a double-blind randomized trial to compare omeprazole, 20 mg once daily, and cimetidine, 800 mg once daily for treatment of duodenal ulcer. The healing rates observed in the omeprazole and cimetidine groups were 65% versus 45% (P less than 0.01) at 2 weeks and 97% versus 85% (P less than 0.01) at 4 weeks. At the end of 4 weeks' treatment, omeprazole achieved equal healing rates (97%) for both large (greater than 10 mm) and small ulcers, whilst cimetidine healed large ulcers at a lower rate than that observed for small ulcers (71% versus 89%). There were significantly fewer reports of daytime epigastric pain after 2 weeks of omeprazole compared with cimetidine (P less than 0.01). No major clinical side-effects or changes in laboratory variables were detected during or after treatment with either drug. In conclusion, omeprazole (20 mg) was found to be superior to cimetidine (800 mg) administered once daily for the treatment of duodenal ulcer as measured by ulcer healing and pain relief.