Ulcer relapse rates following initial treatment with bismuth subnitrate as compared with cimetidine respectively

Abstract

As part of an open clinical trial, 18 out of 23 (78%) patients were treated with bismuth subnitrate (3 x 700 mg/d) and 15 out of 25 (60%) patients were treated with cimetidine (1 x 800 mg/d) to cure peptic ulcers linked with H. pylori, as ascertained following an endoscopic examination. All patients underwent continued observation after complete healing on completion of four weeks of acute treatment. In order to determine the effect of the initial treatment on the rate of relapse, all patients were asked to return for a check-up to establish any relapse, 6 and 12 months following completion of treatment. Gastroduodenoscopy was performed where a recurrent ulcer was suspected. An immediate control examination was carried out if acute symptoms occurred between the controls. In cases of suspected ulcer recurrence, and endoscopic examination was carried out and biopsy specimens were taken in order to detect H. pylori by biochemical and histological tests. In the bismuth group, three relapses (17%) were endoscopically verified 19 to 34 weeks after completion of treatment; 2 patients showed H. pylori positive results. Of the cimetidine group, 6 patients (35%) suffered a recurrent ulcer from the 9th to the 34th week following completion of the acute therapy. Five out of the six patients were H. pylori-positive. A comparison of relapse rates between the two groups was of no statistical significance. Compared with the initial H2 receptor antagonist treatment, there was a distinctly lower relapse rate in patients who were initially treated with bismuth subnitrate.