8 research outputs found
Misoprostol in the Treatment and Prevention of Nonsteroidal Anti-Inflammatory Drug-Induced Gastrointestinal Mucosal Injury
Three studies are discussed with regard to the efficacy of misoprostol,
a synthetic prostaglandin Et analogue, in the treatment and prevention of
NSAID-induced gastroduodenal lesions in patients with rheumatoid arthritis
and osteoarthritis. ln the treatment study, misoprostol was found to be highly
effective in healing aspirin-induced gastroduodenal lesions, eg, intramucosal
hemorrhage, erosions, and gastric and duodenal ulcers, in patients with rheumatoid
arthritis continuing NSAID therapy. Treatment successes were reported in
60% ( week 4) and 70% ( week 8) of patients receiving misoprostol compared with
31% (week 4) and 25% (week 8) of patients receiving placebo (P=0.0001).
Furthermore, misoprostol did not adversely affect anti-inflammatory and analgesic
efficacy of aspirin in rheumatoid arthritis. ln one prevention study, misoprostol
co-administered with therapeutic doses of NSAIDs, was found co be safe
and effective in preventing NSAID-induced gastric ulcers in osteoarthritic
patients. At week 12, 94% of patients on 100 μg misoprostol qid were ulcer-free
versus 99% on 200 μg misoprostol qid and 78% on placebo (P<0.001 ). In a second
prevention study the preliminary analysis of data showed the superior efficacy of
misoprostol compared to sucralfate in preventing NSAID-induced gastric ulcers.
New findings from research on prostaglandin analogues suggest that they may
have therapeutic applications beyond the prevention and treatment of NSAID-induced
gastrointestinal mucosal damage. Misoprostol may protect against-NSAID induced
renal dysfunction, may reduce the damage to cartilage that has been
associated with some NSAIDs, and is associated with a reduction in the incidence
of rejection crises as well as with improvement in renal function in patients
undergoing renal transplantation