The Role of Anticholinergic Drugs in Treatment of Peptic Ulcer Disease

The Medical Treatment of Duodenal Ulceration ?

“…The usual criteria for assessment of their efficacy have been the rate at which symptoms remit and the frequency of symptomatic relapses but the conclusions have varied considerably. Early results were encouraging (Friedlander, 1954; Ruffin and Cayer, 1962; Sun, 1964) but later investigations have failed to confirm this finding (Trevino et al , 1967; Kaye et al , 1970).…”

Modern Drug Treatment for Peptic Ulcer

“…Modem preparations, which tend to be quaternary ammonium compounds, have been claimed to have a more selective anti-secretory effect than atropine, but the evidence that they are clinically useful is by no means convincing. Synthetic anticholinergic drugs have been claimed to produce better symptomatic responses than atropine or placebo tablets (Ruffin & Cayer 1962), and tricyclamol and glycopyrronium have been claimed to reduce the chances of ulcer relapse and complications respectively (Sun 1962(Sun , 1964). By contrast a marginally better initial symptomatic response obtained with methantheline compared with a placebo was not maintained later (Friedlander 1954) and further trials conducted with glycopyrronium, and glycopyrronium or hyoscyamine in maximal doses, respectively showed no difference in the incidence of relapse, or the rate of symptomatic improvement when compared with the responses to dummy tablets (Trevino et al 1967, Kaye et al 1970); results which are in accord with others obtained using synthetic anticholinergic com-pounds (Melrose & Pinkerton 1961, Lennard Jones 1961.…”

A controlled trial of glycopyrronium and l-hyoscyamine in the long-term treatment of duodenal ulcer

“…Final Initial Final A (glycopyrronium) 28 5.0 ± 4-4 8-2 + 5-7 39-6 + 9-8 36-3 + 14-0 B (l-hyoscyamine) 30 6-7 ± 5 7 8-3 ± 4.9 41-6 + 11-8 41-1 + 12-2 C (placebo) 32 6-9 + 8-4 7.0 + 6-1 39-1 ± 10-1 39-2 + 10-7 Friedlander (1954), in a controlled trial in patients with duodenal ulcer, found that methantheline produced initial symptomatic benefit compared with a placebo, but this was not maintained. Later Ruffin and Cayer (1962), in a large double-blind study involving 1,034 patients with peptic ulcer, found that 48 % of patients on placebo, 53% of those on atropine, and 74% of those on synthetic anticholinergics improved. No information, however, is given on the comparability of groups.…”