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.

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💧

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)

Number Needed to Harm (NNH)

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

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💧

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)

Number Needed to Harm (NNH)

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

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💧

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)

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

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💧

DangerousModerateSafe

Time to Effect

Weeks for healing

Duration

4-8 weeks

Response Rate

60%

Remission Rate

50%

Number Needed to Treat (NNT)

Number Needed to Harm (NNH)

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