[Secretin versus cimetidine in the therapy of active bleeding from peptic gastroduodenal lesions. A prospective,...

In a multicentric, prospective, double-blind, randomized trial 101 patients with active bleeding (Forrest, Type 1/b) from gastroduodenal ulcers or erosions were treated with secretin (n = 50, dose: 800 clinic units/24 hours) or cimetidine (n = 51, dose: 75 mg/hour). The bleeding and the effect of the therapy were endoscopically confirmed. The bleeding was stopped during 48 hours of treatment in 36 patients of the secretin treated group and in 25 of the cimetidine treated group (p less than 0.05). In 72 hours the control of bleeding was established in a total of 75 patients (41 secretin, 34 cimetidine; not significant). Surgery was necessary in 7 vs. 9 cases. The mortality was 1 vs. 4 cases. The mean transfusion requirements were 6.6 units in secretin- and 8.2 units in cimetidine treated group (p less than 0.01). There was no difference in rebleeding rate. The results show a trend in favour of secretin compared to cimetidine in the treatment of active bleeding from gastroduodenal ulcers or erosions.