[Is misoprostol effective in NSAID-induced gastrointestinal complications?].
Misoprostol, a synthetic prostaglandin E1, has been shown to reduce both gastric lesions and clinically relevant gastrointestinal events in patients taking NSAIDs. In patients with multiple risk factors gain in quality of life by avoidance of gastric ulcers seems to offset the loss in quality of life due to diarrhea, the most important misoprostol side effect. From a clinical-epidemiological point of view misoprostol prophylaxis thus seems reasonable in patients with multiple risk factors. Since non-use due to diarrhea varies highly among patients, individual preferences should be considered in the decision making process. From an economic point of view misoprostol prophylaxis seems justified in patients with multiple risk factors. In such patients misoprostol prophylaxis may indeed be cost-saving. However, this needs to be confirmed in further economic evaluations based on newly available effectiveness data and better data on patient preferences from large and representative samples.
Stucki
G
G
Rheumaklinik und Institut für physikalische Medizin, Universitätsspital Zürich.
Sangha
O
O
Michel
B A
BA
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D003967:Diarrhea / Q000139:chemically induced; D016527:Drug Costs; D005767:Gastrointestinal Diseases / Q000139:chemically induced / Q000517:prevention & control*; D006801:Humans; D016595:Misoprostol / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D011788:Quality of Life; D012307:Risk Factors; D013276:Stomach Ulcer / Q000139:chemically induced / Q000517:prevention & control
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000897:Anti-Ulcer Agents; D016595:Misoprostol