therapy

TREATING DUODENAL ULCERS: THE CHOICE IS VARIED!

o Trithiozine, a Newcomer on the Market from Italy Ample evidence has been produced of the antisecretory activity of trithiozine (ISF, Italy) and its excellent tolerance [I]. However:

. little is known of its influence on the production of bicarbonate from the pancreas - an important consideration. In 30 patients, including 10 with duodenal ulcer, given PO trithiozine 400mg tid for 10 days there was no evidence of anyinfluence oftrithiozine on the pancreatic secretion of bicarbonate and enzymes. 'This requisite is considered useful, if not necessary, for every antisecretory compound to be used in the medical treatment of peptic ulcer.'

o Encouraging Results With 'Gaviscon', An Antacid Preparation A previous clinical trial suggested that 'Gaviscon' might facilitate healing and relieve the symptoms of duodenal ulcer (alginic acid, sodium alginate, magnesium trisilicate, dried aluminium hydroxide gel and sodium bicarbonate) [2]. A 5-centre study in 62 patients admitted to the trial during exacerbations of the pain of duodenal ulcer showed the drug to be significantly more effective than placebo, but threw little light on why 'Gaviscon' should have any effect on the symptoms of duodenal ulcer. ('Gaviscon' is an alkaline foam that floats on the gastric contents; the pH of which remains unaltered). The study compared 'Gaviscon' with a

placebo tablet containing as much antacid as the standard 'Gaviscon' tablet and with magnesium trisilicate compound tablets BPC. Patients took 2 tablet qid of each preparation. Each treatment was given for periods of 1 day in 8 blocks of 3 days. There was no significant difference on global indigestion ratings, but 'Gaviscon' patients used fewer ' rescue' antacid tablets. There were more side-effects with 'Gaviscon.'

o And Sulglycotide An 8-week study o[sulglycotide('Gliptide') 50mg tid in 98 patients with duodenal ulcers showed the drug to be significantly superior to placebo with regard to healing (3). However, it was disappointing that only 50 % of ulcers had healed in that period. Fifty patients received sulglycotide and 48 placebo. Symptoms improved rapidly during the fIrst two weeks in both groups.

Epigastric tenderness diminished considerably. There were no serious side-effects in either group.

In DobriHa, G. etal.: Acta Therapeutica 3: 247 (No 3. 1977) [2] Chapul de Sainlonge. D.M. et aI.: Practitioner 220: 321 (Feb 1978) [3] Gilmore. A.M. et aI.: Journal of the Irish Medical Association 70: 615 (30 Dec 1977)

INPHARMA 25th March, 1978 p9