DOES LONG-TERM MAINTENANCE THERAPY WITH RANITIDINE AFFECT THE NATURAL COURSE OF DUODENAL-ULCER DISEASE

被引：4
作者：
HOLTMANN, G
ARMSTRONG, D
GOEBELL, H
ARNOLD, R
CLASSEN, M
FISCHER, M
BLUM, AL
机构：
[1] Division of Gastroenterology, University of Essen
[2] Division of Gastroenterology, CHUV, Lausanne
[3] Division of Internal Medicine, University of Marburg
[4] Department of Gastroenterology, Technical University, Munich
[5] Institute of Numerical Statistics, Cologne
来源：
EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY | 1993年 / 5卷 / 05期
关键词：
DUODENAL ULCER; H2-RECEPTOR ANTAGONIST; RANITIDINE; RISK FACTORS; TREATMENT;
D O I：
10.1097/00042737-199305000-00003
中图分类号：
R57 [消化系及腹部疾病];
学科分类号：
摘要：
Objective: To study the course of chronic duodenal ulcer disease and the influence of risk factors on duodenal ulcer relapse after 2 years of maintenance treatment. Design: Prospective multicentre 1-year follow-up study in outpatients. Patients: Nine hundred and sixty-four patients with chronic duodenal ulcerations who had completed 2 years of maintenance treatment (ranitidine 150 mg daily). Main outcome measures: Duodenal ulcer relapse rate. Results: During the 1-year follow-up, 233 patients continued and 731 discontinued maintenance treatment. During this period, 27.7 relapses/100 patients per year [95% confidence interval (Cl) 24.9-30.5] occurred compared with 169.4 relapses/100 patients per year (95% Cl 144-196) before and 7.7 (95% Cl 6.2-9.7) symptomatic and 2.2 (95% Cl 1.3-3.3) asymptomatic relapses/100 patients per year during the 2 years of maintenance treatment. The relapse rate in patients on maintenance treatment during follow-up (14.2 relapse/100 patients per year, 95% Cl 9.7-18.6) was significantly lower than in those without maintenance treatment (32.0 relapses/100 patients per year, 95% Cl 28.6-35.4, P < 0.001). The proportion of patients who relapsed during the first 2 years of maintenance treatment was higher in patients who continued (21%, 95% Cl 15.8-26.3) than in those who discontinued maintenance treatment during follow-up (14.9%, 95% Cl 12.3-17.5, P < 0.01). Patients who relapsed during the first 2 years of maintenance therapy had an increased relapse risk during follow-up (odds ratio 2.43, 95% Cl 1.93-3.05, P < 0.01). Smoking, a history of frequent relapse, heavy physical labour, psychological stress, non-steroidal anti-inflammatory drugs and duodenitis were not associated with an increase in the relapse rate. Conclusion: Maintenance therapy with ranitidine for more than 2 years prevents duodenal ulcer relapse. Cessation of maintenance treatment increases relapse rates which, however, remain markedly lower than those seen prior to maintenance therapy.
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页码：311 / 317
页数：7
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