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A double-blind placebo-controlled comparison of the efficacy and safety of 50, 100, and 200 micrograms of misoprostol QID in the prevention of ibuprofen-induced gastric and duodenal mucosal lesions and symptoms.
Am J Gastroenterol. 1989 Jun; 84(6):633-6.AJ

Abstract

Ibuprofen, a commonly proscribed nonsteroidal anti-inflammatory drug that is also available in many countries, including the United States, without a prescription, is known to cause hemorrhage and erosion of the gastroduodenal mucosa. This study was conducted to compare the efficacy of 200, 100, and 50 micrograms of misoprostol and placebo administered qid for 6 days, with a final dose on the morning of the 7th day, in the prevention of gastric and duodenal lesions induced by the concurrent administration of 800 mg of ibuprofen qid. A total of 120 healthy subjects with endoscopically normal gastric and duodenal mucosae were enrolled in the study. The endoscopic examination was repeated 2 h after the final dose on day 7, and the mucosae were graded on a 0 to 4+ scale. In the stomach, all three misoprostol groups were significantly more protective than placebo and did not differ significantly from each other. In the duodenum, the endoscopic scores of the 200- and 100-micrograms misoprostol groups, but not the 50-micrograms group differed significantly from placebo. The 200- and 100-microgram groups did not differ significantly from each other, but both differed from the 50-micrograms group for duodenal mucosal injury. Subjective symptoms thought to be primarily attributable to the NSAID (e.g., pain, indigestion/heartburn and nausea) were recorded by each subject in a diary. Subjects in the 200-micrograms misoprostol group attained the greatest degree of mucosal protection and had a significantly higher incidence of indigestion/heartburn and abdominal pain than the placebo group. One can conclude that misoprostol in both antisecretory (200- and 100-micrograms) and non-antisecretory (50-micrograms) doses protects the gastric mucosa from injury from high anti-inflammatory doses of ibuprofen (3200 mg/day). Only the antisecretory doses (100 and 200 micrograms qid) were effective in the duodenum, suggesting that acid suppression is necessary for mucosal protection to occur in the duodenum.

Authors+Show Affiliations

Baylor College of Medicine, Section of Gastroenterology, Houston, Texas.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Controlled Clinical Trial
Journal Article

Language

eng

PubMed ID

2499187

Citation

Lanza, F L., et al. "A Double-blind Placebo-controlled Comparison of the Efficacy and Safety of 50, 100, and 200 Micrograms of Misoprostol QID in the Prevention of Ibuprofen-induced Gastric and Duodenal Mucosal Lesions and Symptoms." The American Journal of Gastroenterology, vol. 84, no. 6, 1989, pp. 633-6.
Lanza FL, Fakouhi D, Rubin A, et al. A double-blind placebo-controlled comparison of the efficacy and safety of 50, 100, and 200 micrograms of misoprostol QID in the prevention of ibuprofen-induced gastric and duodenal mucosal lesions and symptoms. Am J Gastroenterol. 1989;84(6):633-6.
Lanza, F. L., Fakouhi, D., Rubin, A., Davis, R. E., Rack, M. F., Nissen, C., & Geis, S. (1989). A double-blind placebo-controlled comparison of the efficacy and safety of 50, 100, and 200 micrograms of misoprostol QID in the prevention of ibuprofen-induced gastric and duodenal mucosal lesions and symptoms. The American Journal of Gastroenterology, 84(6), 633-6.
Lanza FL, et al. A Double-blind Placebo-controlled Comparison of the Efficacy and Safety of 50, 100, and 200 Micrograms of Misoprostol QID in the Prevention of Ibuprofen-induced Gastric and Duodenal Mucosal Lesions and Symptoms. Am J Gastroenterol. 1989;84(6):633-6. PubMed PMID: 2499187.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A double-blind placebo-controlled comparison of the efficacy and safety of 50, 100, and 200 micrograms of misoprostol QID in the prevention of ibuprofen-induced gastric and duodenal mucosal lesions and symptoms. AU - Lanza,F L, AU - Fakouhi,D, AU - Rubin,A, AU - Davis,R E, AU - Rack,M F, AU - Nissen,C, AU - Geis,S, PY - 1989/6/1/pubmed PY - 1989/6/1/medline PY - 1989/6/1/entrez SP - 633 EP - 6 JF - The American journal of gastroenterology JO - Am J Gastroenterol VL - 84 IS - 6 N2 - Ibuprofen, a commonly proscribed nonsteroidal anti-inflammatory drug that is also available in many countries, including the United States, without a prescription, is known to cause hemorrhage and erosion of the gastroduodenal mucosa. This study was conducted to compare the efficacy of 200, 100, and 50 micrograms of misoprostol and placebo administered qid for 6 days, with a final dose on the morning of the 7th day, in the prevention of gastric and duodenal lesions induced by the concurrent administration of 800 mg of ibuprofen qid. A total of 120 healthy subjects with endoscopically normal gastric and duodenal mucosae were enrolled in the study. The endoscopic examination was repeated 2 h after the final dose on day 7, and the mucosae were graded on a 0 to 4+ scale. In the stomach, all three misoprostol groups were significantly more protective than placebo and did not differ significantly from each other. In the duodenum, the endoscopic scores of the 200- and 100-micrograms misoprostol groups, but not the 50-micrograms group differed significantly from placebo. The 200- and 100-microgram groups did not differ significantly from each other, but both differed from the 50-micrograms group for duodenal mucosal injury. Subjective symptoms thought to be primarily attributable to the NSAID (e.g., pain, indigestion/heartburn and nausea) were recorded by each subject in a diary. Subjects in the 200-micrograms misoprostol group attained the greatest degree of mucosal protection and had a significantly higher incidence of indigestion/heartburn and abdominal pain than the placebo group. One can conclude that misoprostol in both antisecretory (200- and 100-micrograms) and non-antisecretory (50-micrograms) doses protects the gastric mucosa from injury from high anti-inflammatory doses of ibuprofen (3200 mg/day). Only the antisecretory doses (100 and 200 micrograms qid) were effective in the duodenum, suggesting that acid suppression is necessary for mucosal protection to occur in the duodenum. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/2499187/A_double_blind_placebo_controlled_comparison_of_the_efficacy_and_safety_of_50_100_and_200_micrograms_of_misoprostol_QID_in_the_prevention_of_ibuprofen_induced_gastric_and_duodenal_mucosal_lesions_and_symptoms_ L2 - https://www.lens.org/lens/search/patent/list?q=citation_id:2499187 DB - PRIME DP - Unbound Medicine ER -