A therapeutic trial of 15 (R)-15-methyl prostaglandin E2 in rheumatoid arthritis patients with gastroduodenal lesions.
Thirteen patients who had rheumatoid arthritis and gastroduodenal lesion (erosions, ulcers) received 200 micrograms/d of 15(R)-15-methyl prostaglandin E2 (MPGE2) for one month in a controlled, randomized, double-blind crossover study. The patients continued their usual arthritis medications. Serial assessments were made with endoscopy and multiple antral biopsies. Seven patients improved on MPGE2 and 3 improved on placebo. Two patients worsened on MPGE2 compared with 3 on placebo. No dramatic benefit was observed after one month of therapy with MPGE2, although a moderate benefit could have been missed in a small study of this type. Our experience with this study suggests that future studies in rheumatoid arthritis should first establish the natural history of lesions in a given group of patients, that a cross-over design may actually hamper interpretation and that therapy should be more prolonged.
D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use; D001101:Arbaprostil / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000150:complications*; D002986:Clinical Trials as Topic; D004311:Double-Blind Method; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced / Q000188:drug therapy*; D006801:Humans; D008875:Middle Aged; D011459:Prostaglandins E, Synthetic / Q000627:therapeutic use*
D000893:Anti-Inflammatory Agents; D011459:Prostaglandins E, Synthetic; D001101:Arbaprostil