Maintenance therapy with sucralfate in duodenal ulcer: genuine prevention or accelerated healing of ulcer recurrence?

Article Abstract:

Sucralfate is a medication that has proved effective in the treatment of stomach ulcers and duodenal ulcers. Sucralfate clearly promotes the healing of ulcers, but its mechanisms are uncertain. Furthermore, it is difficult to interpret some data on the effectiveness of sucralfate in the maintenance of ulcer patients and the prevention of recurrences. Many clinical trials designed to evaluate sucralfate's effect on ulcer recurrences have reported the cumulative percentage of ulcers that have recurred during some time interval. Such results can be misleading. A patient may appear to be free of ulcers because a drug has protected his stomach from ulcers. However, the same patient might appear free of ulcers because the drug has affected the pain of ulcers, or he might appear free of ulcers because, although the ulcers are recurring, the drug treatment is healing them before symptoms appear. One way of circumventing these problems is the direct observation of ulcers using the fiber optic endoscope. By direct visualization, ulcers can be counted and recorded, regardless of whether or not they cause the patient symptoms. In an experimental study of 254 patients with duodenal ulcers, endoscopic examination was performed at monthly intervals. The patients were randomly assigned to receive sucralfate or placebo, but if a developing ulcer was observed in the endoscope, the patient was invariably given sucralfate. In this manner, it was possible to document the actual rates of ulcer recurrence, not merely the recurrence of symptoms or the results of accelerated healing. This method confirmed that maintenance therapy with sucralfate reduced the rate of ulcer recurrence. More importantly, however, the study demonstrated that this observed freedom of ulcers actually results from a decrease in new ulcers in the group treated with sucralfate when compared with the placebo-treated patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Prevention, Physiological aspects, Duodenal ulcer

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Comparative study of sucralfate 2 grams twice daily versus sucralfate 1 gram four times daily in the treatment of benign gastric ulcers in outpatients

Article Abstract:

Sucralfate is an effective medication in the treatment of peptic ulcers. It is customary to treat most stomach ulcers with a one gram dose of sucralfate given one-half to one hour before each meal and before bed. Studies on patients with duodenal ulcers have shown, however, that a twice-daily dose of two grams (total dose four grams per day) is just as effective as the four times a day (q.i.d) regimen. A study was therefore conducted to determine if a similar reduction in the number of doses might be just as effective for stomach ulcers. The study was conducted on 52 patients with stomach ulcers; in each case the ulcer was confirmed by direct examination with the fiber-optic endoscope. Eight weeks and 12 weeks after the initiation of treatment, the ulcers were again examined endoscopically. At the end of 12 weeks, the healing rate among the twice-a-day dose group was 92 percent, in contrast with the 71 percent rate in the q.i.d. group. Statistical analysis suggested that this difference was not significant. There was, however, indication that patients complied better with the twice-a-day schedule. There appears to be no reason not to adopt the twice-a-day sucralfate regimen for the treatment of patients with stomach ulcers. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Dosage and administration

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Similar abstracts:

• Abstracts: Treatment of peptic ulcer disease with sucralfate: a review. Comparison of sucralfate and ranitidine in the treatment of duodenal ulcers

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