Condition

Peptic ulcer disease

Clinical trials and treatment information for Peptic ulcer disease

6.6M
People Affected
150
Active Trials
328K
New Cases/Year
230K
Deaths/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

1
H. pylori Eradication (Quadruple Therapy)
88% Effectiveness• 90% Confidence• 68% Safety• 14 trials• 100K participants
HIGH EvidenceExcellent ValueDose: Standardized regimens (e.g., PPI BID, Bismuth QID, Metronidazole QID, Tetracycline QID for 10-14 days)
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
68
DangerousModerateSafe

Time to Effect

10-14 days for eradication, weeks for ulcer healing

Duration

10-14 days for antibiotics/bismuth, PPI often continued for 2-4 weeks

Response Rate

88%

Remission Rate

82%

Number Needed to Treat (NNT)

5

Number Needed to Harm (NNH)

15

Common Side Effects:

Diarrhea: 15%
Nausea: 10%
Abdominal pain: 8%
Black stool/tongue (Bismuth): 25%
Dysgeusia (Metronidazole, Clarithromycin): 15%

Annual Cost of Care

Drug Cost

$100

Monitoring

$300

Side Effects

$50

Total Annual

$450

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.1

ICER

$30,000/QALY

Cost per Remission

$548.78

Cost per Responder

$511.36

Treatment Outcomes
Primary Outcomes
H. pylori Presence (post-treatment confirmation)100% of patients positive for H. pylori
-88% (Reduced to 12% of patients positive)
Peptic Ulcer Healing (Endoscopic confirmation)0% ulcers healed (all active)
+85% (85% ulcer healing rate)
Dyspepsia Severity (based on GSRS dyspepsia subscale)3.8 points (on a 1-7 scale, moderate severity)
-60% (-2.3 points (e.g., from 3.8 to 1.5 points))
Peptic Ulcer Recurrence (1-year post-eradication)70% 1-year recurrence rate (if H. pylori persists)
-80% (Reduced to ~14% 1-year recurrence)
Secondary Benefits
Health-Related Quality of Life (e.g., SF-36 PCS Score)42 points (on a 0-100 scale, population norm 50)
+12% (+5 points (e.g., from 42 to 47 points))
Gastric Mucosal Inflammation (Sydney System Activity Score)2.5 points (on a 0-3 scale, moderate-severe)
-70% (-1.75 points (e.g., from 2.5 to 0.75 points))
Hemoglobin Levels (in patients with baseline anemia due to GI bleeding)10.5 g/dL
+15% (+1.6 g/dL (e.g., from 10.5 to 12.1 g/dL))
Common Side Effects
Diarrhea
+15%
Nausea
+10%
Abdominal pain
+8%

Clinical Trial Phases:

Phase 4
2
Omeprazole (Proton Pump Inhibitor)
88% Effectiveness• 95% Confidence• 75% Safety• 19 trials• 500K participants
HIGH EvidenceExcellent ValueDose: 20-40mg once daily
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
75
DangerousModerateSafe

Time to Effect

1-2 weeks for symptom relief, 4-8 weeks for healing

Duration

4-8 weeks for acute, often longer for maintenance

Response Rate

88%

Remission Rate

78%

Number Needed to Treat (NNT)

3

Number Needed to Harm (NNH)

75

Common Side Effects:

Headache: 8%
Nausea: 4%
Diarrhea: 4%

Annual Cost of Care

Drug Cost

$40

Monitoring

$100

Side Effects

$20

Total Annual

$160

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.2

ICER

$15,000/QALY

Cost per Remission

$205.13

Cost per Responder

$181.82

Treatment Outcomes
Primary Outcomes
Heartburn Severity Score (3-point scale)2.5/3
-80% (-2.0 points)
Dyspepsia Severity Score (0-10 VAS)6.0/10
-75% (-4.5 points)
Gastric Ulcer Healing Rate (after 8 weeks)Ulcer present (0% patients healed)
+85% (+85% of patients)
Duodenal Ulcer Healing Rate (after 4 weeks)Ulcer present (0% patients healed)
+90% (+90% of patients)
Secondary Benefits
Nocturnal Heartburn Episodes (per week)4 episodes/week
-75% (-3 episodes/week)
GI-Specific Quality of Life Score (0-100 scale)45/100
+55.6% (+25 points)
Gastric Pain Score (0-10 VAS)7/10
-71.4% (-5 points)
Common Side Effects
Headache
+8%
Nausea
+4%
Diarrhea
+4%

Clinical Trial Phases:

Phase 4
3
Famotidine (H2-Receptor Antagonist)
70% Effectiveness• 90% Confidence• 80% Safety• 4 trials• 100K participants
HIGH EvidenceExcellent ValueDose: 20-40mg once or twice daily
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
80
DangerousModerateSafe

Time to Effect

1-2 weeks for symptom relief, 6-8 weeks for healing

Duration

6-8 weeks for acute, often longer for maintenance

Response Rate

70%

Remission Rate

60%

Number Needed to Treat (NNT)

5

Number Needed to Harm (NNH)

100

Common Side Effects:

Headache: 3%
Dizziness: 1%
Nausea: 1%

Annual Cost of Care

Drug Cost

$30

Monitoring

$100

Side Effects

$10

Total Annual

$140

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.15

ICER

$8,000/QALY

Cost per Remission

$233.33

Cost per Responder

$200

Treatment Outcomes
Primary Outcomes
Daytime Epigastric Pain IntensityMean daily pain score (0-3 scale): 2.2
-65% (-1.43 points)
Nighttime Epigastric Pain IntensityMean nightly pain score (0-3 scale): 1.8
-70% (-1.26 points)
Duodenal Ulcer Average DiameterAverage diameter: 8 mm
-75% (-6 mm)
Gastric Ulcer Average DiameterAverage diameter: 10 mm
-70% (-7 mm)
Secondary Benefits
Overall PUD Symptom Severity (0-100 scale)PUD Symptom Severity Scale: 60 points
-55% (-33 points)
Daily Antacid ConsumptionAverage antacid tablets/day: 4
-75% (-3 tablets/day)
Basal Acid Output5 mEq/hr
-70% (-3.5 mEq/hr)
Common Side Effects
Headache
+3%
Dizziness
+1%
Nausea
+1%

Clinical Trial Phases:

Phase 4
4
Sucralfate
60% Effectiveness• 70% Confidence• 85% Safety• 100 trials• 20K participants
MODERATE EvidenceGood ValueDose: 1g four times daily
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
85
DangerousModerateSafe

Time to Effect

Weeks for healing

Duration

4-8 weeks

Response Rate

60%

Remission Rate

50%

Number Needed to Treat (NNT)

6

Number Needed to Harm (NNH)

50

Common Side Effects:

Constipation: 7%
Dry mouth: 1%

Annual Cost of Care

Drug Cost

$150

Monitoring

$50

Side Effects

$20

Total Annual

$220

Cost-Effectiveness

GOOD

QALYs Gained

0.08

ICER

$25,000/QALY

Cost per Remission

$440

Cost per Responder

$366.67

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+60%
Response Rate
+60%
Remission Rate
+50%
Common Side Effects
Constipation
+7%
Dry mouth
+1%

Clinical Trial Phases:

Phase 4