MAINTENANCE THERAPY IN PEPTIC-ULCER DISEASE

Recent endoscopically controlled trials of drug treatment for peptic ulcer disease have demonstrated that the majority of both duodenal and gastric ulcers relapse within 12 months after healing. A group of risk factors has been defined that may help identify those patients at greatest risk for ulcer recurrence. Maintenance treatment with approximately half the dose of the drug used to heal the ulcer is usually effective in preventing ulcer relapse. This article discusses the magnitude of the problem of ulcer relapse, complications that may result, risk factors that predict relapse, and the various treatment regimens proposed for maintenance therapy, including comments about cost efficacy. The article concludes with a summary outlining a clinical approach for management of both low- and high-risk ulcer patients.