[Prostaglandin analogues in the treatment of peptic ulcer disease].
The cytoprotective properties of native prostaglandins have been exploited for ulcer therapy through the development of analogous molecules, which are characterized by longer duration of action, more potent acid inhibitory effect and higher pharmacologic specificity. The therapeutic efficacy of prostaglandin analogues has been evaluated in a variety of controlled clinical trials, which are summarized briefly. The experience with arbaprostil, enprostil, misoprostol, rioprostil and trimoprostil shows that their effect on ulcer healing is superior to that of a placebo in acid inhibitory doses, which are also cytoprotective. Nevertheless, prostaglandin analogues are inferior to H2-receptor antagonists as regards their effects on ulcer healing, pain relief, and relapse prevention and less effective than expected from their acid inhibitory action. Placebo controlled trials of arbaprostil in acute upper gastrointestinal haemorrhage have failed to demonstrate any reduction in numbers of patients whose bleeding stopped, numbers with rebleeding or transfusion requirement. Diarrhoea occurs in 4%-34% of all patients and prostaglandin analogues are contraindicated in pregnant women. Although these drugs will probably not be marketed in Denmark for ulcer therapy, they may prove useful as replacement therapy in patients requiring nonsteroidal antiinflammatory drugs.
Laursen
L S
LS
Havelund
T
T
Lauritsen
K
K
Madsen
J R
JR
D006801:Humans; D010437:Peptic Ulcer / Q000188:drug therapy*; D011465:Prostaglandins, Synthetic / Q000627:therapeutic use*
D011465:Prostaglandins, Synthetic
Prostaglandinanaloger i behandling af ulcussygdommen.