Nonsteroidal peptic damage in rheumatoid patients receiving second-line drugs.
Using endoscopy, we assessed the prevalence of peptic ulceration in 281 rheumatoid patients receiving nonsteroidal antiinflammatory drugs alone, or in combination with second-line agents. Ulcers were found in 33 of 96 patients who took nonsteroidals only (33/96, 34%), compared with 8/33 (24%) on hydroxychloroquine, 10/30 (33%) on penicillamine, 13/46 (28%) on sulphasalazine, but only 11/76 (14%) on intramuscular gold plus nonsteroidals (chi 2 = 7.95, 0.001 less than p less than 0.01, p less than 0.05 using Bonferroni correction). Second-line drugs do not seem to increase the prevalence of ulcers related to nonsteroidal antiinflammatory drugs; on the contrary, fewer ulcers were found in patients receiving gold therapy, and this might have therapeutic implications.
Gastroenterology Unit, Royal Infirmary, Glasgow, Scotland, United Kingdom.
A S
AS
Taha
H A
HA
Capell
R D
RD
Sturrock
R I
RI
Russell
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D004359:Drug Therapy, Combination; D016145:Endoscopy, Digestive System; D005260:Female; D006052:Gold Sodium Thiomalate / Q000627:therapeutic use; D006801:Humans; D006886:Hydroxychloroquine / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010396:Penicillamine / Q000627:therapeutic use; D010437:Peptic Ulcer / Q000139:chemically induced* / Q000473:pathology; D012460:Sulfasalazine / Q000627:therapeutic use
D000894:Anti-Inflammatory Agents, Non-Steroidal; D006052:Gold Sodium Thiomalate; D012460:Sulfasalazine; D006886:Hydroxychloroquine; D010396:Penicillamine