Cimetidine in the treatment of gastric ulcer induced by steroidal and nonsteroidal anti-inflammatory agents.

The study of a group of patients with gastric ulcers induced by anti-inflammatory agents, was undertaken in an attempt to ascertain the effectiveness of cimetidine (Tagamet) when compared with intensified doses of antacids in their treatment. Seventy patients with medication-induced benign gastric ulcers confirmed by endoscopy and biopsy were studied. The agents principally responsible were aspirin, prednisone, ibuprofen, indomethacin, and sulindac in standard pharmacologic doses. The study was carefully controlled to exclude confusing parameters. Patients were divided into two groups. Group 1 (38 patients) received cimetidine plus and antacid (Maalox). Group 11 (32 patients) received placebo tablets plus the same dose of antacid as in Group 1. All anti-inflammatory agents were discontinued and patients were instructed to avoid known gastric irritants. Treatment periods lasted six weeks. Confirmation of healing was by endoscopic evaluation. A significant difference was noted only with respect to treatment response. Twenty-five of the 38 patients (65.7%) in group 1 receiving cimetidine plus antacid had their ulcers healed within the six-week period. Only eight of the 32 patients (25%) in Group 11 receiving placebo plus antacid had ulcer healing within this period of time (P less than .001). We conclude that a regimen of cimetidine plus intensified antacid therapy is far superior to the same dose of antacid alone in the treatment of gastric ulcer induced by anti-inflammatory agents.