The influence of cimetidine on peptic ulcer in patients with arthritis taking anti-inflammatory drugs.

Patients with arthritis who take nonsteroidal anti-inflammatory drugs (NSAIDs) often develop peptic ulceration. Withdrawal of the NSAID may lead to increased debility and thus it may be desirable to continue the NSAID while attempting to heal the ulceration by additional therapeutic measures. We have investigated the effect of cimetidine in this role. Patients with gastroscopically-proven peptic ulcer associated with NSAID ingestion were given either cimetidine or placebo treatment while continuing to take their NSAIDs. It was found that the ulceration healed in some patients over a 6-week period even on placebo treatment. There was no statistical difference found between the healing of these ulcers when compared with the cimetidine-treated group. The mechanism of NSAID-induced ulceration and the reason for the above finding is discussed.