Long-term treatment of duodenal ulcer with cimetidine. Intermittent or continuous therapy?

Forty-eight patients with chronic duodenal ulcers which were healed with cimetidine were allocated at random into two equal groups to assess different ways of using cimetidine during one year of treatment. Twenty-four patients received intermittent six-week courses of cimetidine for each relapse, and 24 patients were treated with maintenance administration of cimetidine (400 mg twice a day) continuously. Only one patient in the group receiving continuous therapy suffered clinical recurrence, but asymptomatic ulceration was found in four others. The group of patients who were receiving intermittent therapy suffered a total of 36 clinical recurrences. Three of these patients required prolonged treatment to heal their ulcers, and seven developed asymptomatic ulcer. The number of relapses varied from none to five. No way of predicting the individual prognosis was found. Intermittent treatment was an acceptable alternative in approximately half of the patients treated in this way, and was a failure in one-quarter of the group.