title: A double-blind comparison of the gastroduodenal safety and efficacy of diclofenac and a fixed dose combination of diclofenac and misoprostol in the treatment of rheumatoid arthritis.
abstract: This double-blind, parallel group study was conducted to evaluate the gastroduodenal safety and antiarthritic efficacy of a fixed combination of diclofenac sodium 50 mg and misoprostol 200 mcg, compared with a combination of diclofenac 50 mg and placebo. Three hundred and thirty-nine patients with rheumatoid arthritis and no significant gastric or duodenal mucosal damage were enrolled and received study medication (diclofenac/misoprostol, 164; diclofenac/placebo, 175) BID or TID for 12 weeks. Posttreatment gastroduodenal endoscopic examinations revealed ulcers in 11% of the diclofenac/placebo group, compared with only 4% of the diclofenac/misoprostol group (p = 0.034). Four-weekly assessments of arthritic condition revealed no clinically or statistically significant treatment differences. It was concluded that diclofenac/misoprostol caused significantly less gastroduodenal damage than diclofenac, but was as effective as diclofenac alone in the treatment of rheumatoid arthritis.
authors.affiliation: Algemeen Ziekenhuis St. Jozef, Turnhout, Belgium.
authors.forename: W
authors.initials: W
authors.lastname: Verdickt
authors.forename: C
authors.initials: C
authors.lastname: Moran
authors.forename: H
authors.initials: H
authors.lastname: Hantzschel
authors.forename: A M
authors.initials: AM
authors.lastname: Fraga
authors.forename: H
authors.initials: H
authors.lastname: Stead
authors.forename: G S
authors.initials: GS
authors.lastname: Geis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D004008:Diclofenac / Q000592:standards* / Q000627:therapeutic use*; D004064:Digestive System / Q000187:drug effects*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004381:Duodenal Ulcer / Q000139:chemically induced / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016595:Misoprostol / Q000627:therapeutic use*; D013276:Stomach Ulcer / Q000139:chemically induced / Q000517:prevention & control
chemical_list: D016595:Misoprostol; D004008:Diclofenac