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Factors predicting the therapeutic outcome of duodenal ulcer treatment with H2-receptor antagonists

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Summary

In a prospective trial 37 duodenal ulcer patients were treated daily with 1 g cimetidine. Personal and clinical data were obtained for all patients, acid secretion studies performed before and during treatment, and pharmacokinetic parameters of cimetidine determined. The healing rate after 4 weeks was 64.9% (24 patients). Non-Responders included a higher proportion of smokers, patients with a history of ulcer and previous treatment with H2-receptor antagonists than Responders. Basal acid output (BAO) and peak acid output (PAO) values were not different between the two groups, nor was the reduction of BAO and PAO under cimetidine. However, more Responders had complete suppression of BAO than Non-Responders. A correlation existed in both groups between cimetidine plasma concentration and PAO suppression but not with BAO suppression. Regular drug intake (compliance) was found in about 90% in both groups. Cimetidine bioavailability parameters were identical in both groups, but Non-Responders had a higher peak concentration and a shorter time of peak concentration. Discriminant analysis enabled a prediction of treatment response in 89.2% of the patients by using five factors: time of peak concentration of cimetidine, previous H2-receptorantagonist treatment, peak concentration, smoking, and alcohol use. Prediction of treatment response is increased by use of drug related variables.

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Abbreviations

BAO:

basal acid output

Cmax :

peak concentration

PAO:

peak acid output

Tmax :

time of peak concentration

T>0.5:

time of effective plasma concentrations

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Authors and Affiliations

  1. Medizinische Klinik der Universität Bonn, Germany

    R. Gugler, J. C. Jensen & A. Somogyi

  2. St. Barbara-Hospital Gladbeck, Germany

    H. G. Rohner

  3. Institut für Medizinische Statistik, Dokumentation und Datenverarbeitung Bonn, Germany

    P. Reimnitz

Authors
  1. R. Gugler
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  2. J. C. Jensen
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  3. H. G. Rohner
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  4. P. Reimnitz
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  5. A. Somogyi
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Dedicated to Professor Dr. Hans J. Dengler on the occasion of his 60th birthday

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Gugler, R., Jensen, J.C., Rohner, H.G. et al. Factors predicting the therapeutic outcome of duodenal ulcer treatment with H2-receptor antagonists. Klin Wochenschr 63, 1152–1159 (1985). https://doi.org/10.1007/BF01740590

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  • DOI: https://doi.org/10.1007/BF01740590

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