One hundred and six patients with active gastric ulcer proven by endoscopy were randomly allocated to receive cimetidine 800 mg at bedtime + teprenone 50 mg thrice daily; or cimetidine 800 mg at bedtime alone in a trial comparing the ulcer healing rate and the quality of healing at 4 or 8 weeks. At 4 weeks 72.4% (42/58) of those on cimetidine + teprenone and 52.1% (25/48) on cimetidine alone had ulcers healed in comparison of 93.1% (54/58) and 89.6% (43/48) respectively at 8 weeks. The difference was significant at 4 weeks, indicating the ulcer heal more rapidly in the combination therapy group. The stage S2 achievement rates were 34.5% (20/58) and 10.4% (5/48) at 4 weeks (P < 0.05), 50.0% (29/58) and 20.8% (10/48) at 8 weeks (P < 0.05) respectively, indicating the quality of ulcer healing was much better in the combination therapy group. The gastric mucosal hexosamine levels increase significantly after treatment (17.79 +/- 2.00 micrograms/mg) as compared to that before treatment (14.27 +/- 2.47 micrograms/mg) in the combination therapy group, indicating that teprenone stimulates macromolecular glycoprotein synthesis in gastric mucosa. This is thought to be a significant factor in the healing process of gastric ulceration.
Conclusion: It is reasonable to administer teprenone, an agent increasing mucosal resistance, concurrently with H2 blockers in the treatment of active gastric ulcers.