THE PREVENTION AND HEALING OF ACUTE NON-STEROIDAL ANTI-INFLAMMATORY DRUG-ASSOCIATED GASTRODUODENAL MUCOSAL DAMAGE BY MISOPROSTOL

This double-blind study assessed the acute development of NSAID-associatedgastroduodenal (GD) damage and its prevention by misoprostol.Patients requiring chronic NSAID therapy were stratified intotwo groups depending on initial endoscopic appearance, Group1: normal (n = 223); Group 11: non-ulcer lesions (n = 78). After2 weeks of therapy with NSAID and either misoprostol 400–800µg daily or placebo the incidence of severe mucosal damage(including ulcers) was significantly reduced by misoprostol(odds ratio; 95% CI). Group 1: 4.52; 1.94, 10.51 (P = 0.018);Group II: 10.93; 1.09, 109.60 (P = 0.014); Groups I and II combined:5.95; 3.23, 10.94 (P = 0.0003). Misoprostol exerted a significantprotective effect against progression of minor to severe damagein Group II (P<0.001). Endoscopic findings did not correlatesignificantly with gastrointestinal symptoms and misoprostoldid not interfere with the NSAID efficacy. Significant GD damageoccurs early in the course of NSAID treatment and misoprostolsignificantly reduces the incidence of such damage. KEY WORDS: Gastroduodenal damage, Non-steroidal anti-inflammatory drugs